[1]郭雄飞,王　挺,汤立新.脊柱手术后切口感染患者病原菌分布及耐药性和血清炎性因子水平分析[J].新乡医学院学报,2019,36(10):963-966.[doi:10.7683/xxyxyxb.2019.10.014]
　GUO Xiong-fei,WANG Ting,TANG Li-xin.Distribution of pathogenic bacteria and analysis of drug resistance and the levels of serum inflammatory factors in patients with incision infection after spinal operation[J].Journal of Xinxiang Medical University,2019,36(10):963-966.[doi:10.7683/xxyxyxb.2019.10.014]
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脊柱手术后切口感染患者病原菌分布及耐药性和血清炎性因子水平分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年10
页码:
963-966
栏目:
临床研究
出版日期:
2019-10-05

文章信息/Info

Title:
Distribution of pathogenic bacteria and analysis of drug resistance and the levels of serum inflammatory factors in patients with incision infection after spinal operation
作者:
郭雄飞; 王　挺; 汤立新
（南阳市中心医院骨一科，河南　南阳　473000）
Author(s):
GUO Xiong-fei; WANG Ting; TANG Li-xin
(Department of Osteology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)
关键词:
脊柱手术; 切口感染; 病原菌分布; 耐药性; 炎性因子
Keywords:
spinal operation; incision infection; distribution of pathogenic bacteria; drug resistance; inflammatory factor
分类号:
R372
DOI:
10.7683/xxyxyxb.2019.10.014
文献标志码:
A
摘要:
目的　分析脊柱手术后切口感染病原菌分布及耐药性和患者血清炎性因子表达情况。方法　选择2015年7月至2018年6月于南阳市中心医院行脊柱手术后切口感染患者60例（感染组）和术后切口未感染患者60例（未感染组）为研究对象，并选择同期体检健康者60例为健康对照组；统计分析感染组患者的病原菌分布情况及其耐药性，并分析感染组、未感染组、健康对照组受试者血清炎性因子肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）、超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）水平的差异。结果　感染组患者共分离出病原菌145株，其中革兰阴性菌98株（67.59%），革兰阳性菌42株（28.97%），真菌5株（3.45%%）。革兰阴性菌中，铜绿假单孢菌对头孢唑林、氨苄西林、呋喃妥因和左氧氟沙星的耐药率较高，肺炎克雷伯菌对氨苄西林、头孢西丁、头孢唑林和四环素的耐药率较高，大肠埃希菌对头孢唑林、左氧氟沙星、氨苄西林、环丙沙星和四环素的耐药率较高。革兰阳性菌中，屎肠球菌对红霉素、克林霉素、利福平、氨苄西林、左氧氟沙星、环丙沙星和青霉素的耐药率较高，粪肠球菌对克林霉素、四环素、利福平、氨苄西林和左氧氟沙星的耐药率较高。感染组患者血清TNF-α、PCT、hs-CRP、IL-6、IL-8水平显著高于未感染组和健康对照组（P<0.05），未感染组患者血清TNF-α、PCT、hs-CRP、IL-6、IL-8水平显著高于健康对照组（P<0.05）。结论　脊柱手术后切口感染的病原菌主要为革兰阴性菌，临床应根据药物敏感性试验结果合理选择敏感抗菌药物进行治疗；脊柱手术后切口感染患者血清炎性因子水平升高，临床可通过监测炎性因子水平来评估感染情况。
Abstract:
Objective　To analyze the distribution of pathogenic bacteria,drug resistance and the expression of inflammatory factors in patients with incision infection after spinal operation.Methods　Sixty patients with incision infection (infection group) and 60 patients without incision infection (non-infection group) after spinal operation in Nanyang Central Hospital from July 2015 to June 2018 were selected as the subjects,and sixty healthy subjects in the same period were selected as the healthy control group.The distribution and drug resistance of pathogenic bacteria in patients of infection group were analyzed.non-infected group and healthy control group were analyzed.The differences of the levels of serum inflammatory factors were analyzed in the infection group,the non-infection group and the healthy control group,including tumor necrosis factor-α(TNF-α),procalcitonin (PCT),high-sensitivity C-reactive protein (hs-CRP),interleukin-6 (IL-6) and interleukin-8 (IL-8).Results　A total of 145 strains of pathogenic bacteria were isolated from the patients in the infection group,including 98 (67.59%) strains of Gram-negative bacteria,42(28.97%) strains of Gram-positive bacteria and 5 (3.45%) strains of fungi.Among the gram-negative bacteria,the resistance rate of Pseudomonas aeruginosa to cefazolin,ampicillin,furantoin and levofloxacin was high;the resistance rate of Klebsiella pneumoniae to ampicillin,cefoxitin,cefazolin and tetracycline was high;the resistance rate of Escherichia coli to cefazolin,levofloxacin,ampicillin,ciprofloxacin and tetracycline was high.Among the Gram-positive bacteria,the resistance rate of Enterococcus faecium to erythromycin,clindamycin,rifampicillin,ampicillin,levofloxacin,ciprofloxacin and penicillin was high;the resistance rate of Enterococcus faecalis to clindamycin,tetracycline,rifampicin,ampicillin and levofloxacin was high.The levels of serum TNF-α,PCT,hs-CRP,IL-6 and IL-8 in the infection group were significantly higher than those in the non-infection group and the healthy control group (P<0.05).The levels of serum TNF-α,PCT,hs-CRP,IL-6 and IL-8 in the non-infection group were significantly higher than those in the healthy control group (P<0.05).Conclusion　The Gram-negative bacteria are the main pathogens of incision infection after spinal operation,and the sensitive antibacterial should be selected reasonably according to the results of drug sensitivity test.The levels of serum inflammatory factors increased in patients with incision infection after spinal operation,and the infected situation can be assessed by monitoring the levels of inflammatory factors.

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更新日期/Last Update: 2019-10-05