CAJ | 학술논문

目的：对胃癌患者行根治性切除术后腹腔感染的病原学特征进行回顾性分析。方法回顾性分析479例胃癌患者根治术后腹腔感染的病原学种类及药敏结果。结果479例患者中32例术后出现腹腔感染（6.68%），病原学阳性者27例，阳性率为84.38%。检出病原菌32株，其中革兰阴性菌24株（75.00%），包括大肠埃希菌15株（46.86%），肺炎克雷伯菌3株（9.38%），普通变形杆菌、奇异变形杆菌、阴沟肠杆菌、普城沙雷菌、不动杆菌及铜绿假单胞菌各1株（各占3.13%）；革兰阳性菌7株（21.88%），包括粪肠球菌4株（12.50%），耐久肠球菌、金黄色葡萄球菌及溶血性葡萄球菌各1株（3.13%）；真菌1株（3.13%）。药敏结果显示32株病原菌中，对常用抗菌药物的耐药率较高，其中革兰阴性菌对美洛培南敏感性最高（91.67%），而革兰阳性菌对万古霉素最为敏感（85.71%）。结论大肠埃希菌、粪肠球菌、肺炎克雷伯菌是胃癌患者根治术后腹腔感染最主要的致病菌，临床上应注意合理使用抗菌药物。
목적：대위암환자행근치성절제술후복강감염적병원학특정진행회고성분석。방법회고성분석479례위암환자근치술후복강감염적병원학충류급약민결과。결과479례환자중32례술후출현복강감염（6.68%），병원학양성자27례，양성솔위84.38%。검출병원균32주，기중혁란음성균24주（75.00%），포괄대장애희균15주（46.86%），폐염극뢰백균3주（9.38%），보통변형간균、기이변형간균、음구장간균、보성사뢰균、불동간균급동록가단포균각1주（각점3.13%）；혁란양성균7주（21.88%），포괄분장구균4주（12.50%），내구장구균、금황색포도구균급용혈성포도구균각1주（3.13%）；진균1주（3.13%）。약민결과현시32주병원균중，대상용항균약물적내약솔교고，기중혁란음성균대미락배남민감성최고（91.67%），이혁란양성균대만고매소최위민감（85.71%）。결론대장애희균、분장구균、폐염극뢰백균시위암환자근치술후복강감염최주요적치병균，림상상응주의합리사용항균약물。
Objective To analyze the epidemiology characteristics of bacteria in postoperative intra-abdominal infection after radical gastrectomy, retrospectively. Methods Data of 479 patients undergoing radical gastrectomy were collected. The species of the pathogens responsible for postoperative intra-abdominal infection and the result of drug susceptibility were analyzed, retrospectively. Results There were 32 (6.68%) among the 479 patients were suffered from postoperative intra-abdominal infection, in which 27 (84.38%) patients had positive pathogen detection. Total of 32 bacilli lines were separated, of which 24 (75.00%) strains were Gram-negative bacilli, including 15 (46.86%) strains of Escherichia coli, 3 (9.38%) strains of Klebsiellap pneumonia and one strains of Proteus vulgaris, Proteus mirabilis, Enterobacter cloacae, Princeton marcescens, Acinetobacter and Pseudomonas aeruginosa, respectively (3.13%). There were 7 (21.88%) strains of Gram-positive bacilli were separated, including 4 (12.50%) strains of Enterococcus faecali, one strains of Enterrococcus durali, Staphylococcus aureus and Staphylococcus hemolytic, respectively (3.13%). Furthermore, one (3.13%) strains of Candida albicans was separated. Drug resistance rate of the separated pathogens to common-used antibiotics were relatively high. Drug susceptibility rate of Gram-negative bacteria to meropenem (91.67%) and Gram-positive bacteria to vancomycin (85.71%) was the highest, respectively. Conclusions The most common pathogens causing intra-abdominal infection after radical gastrectomy are Escherichia coli, Enterococcus faecali and Klebsiellap pneumonia, thus we should use antibiotics rationally.