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在腹部手术中,直肠殖民是多药耐药细菌在手术部位感染的预测因素

Matthias Mehdorn¹, Susanne Kolbe-Busch², Norman Lippmann³

¹Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstraße 20, 04103, Leipzig, Germany. Matthias.mehdorn@medizin.uni-leipzig.de.

Langenbeck's archives of surgery

|June 10, 2023

概括

在腹部手术后,直肠殖民是多耐药生物体 (MDRO) 手术部位感染 (SSI) 的主要危险因素. 识别直肠殖民可以改善MDROs的SSI预防策略.

科学领域:

外科手术感染.
微生物学微生物学
传染病流行病学传染病流行病学

背景情况:

在腹部手术后,表面手术部位感染 (SSI) 是常见的.
多药耐药生物 (MDRO) 构成了越来越大的医疗保健挑战.
关于MDROs作为SSI代理物的证据在各个外科领域和地区各不相同.

研究的目的:

在腹部手术患者中调查MDRO引起的SSI的患病率和危险因素.
确定导致SSI的特定MDRO及其来源.
为SSI预防策略提供有关MDRO的信息.

主要方法:

针对 SSI 的腹部手术患者进行机构伤口登记 (2015-2018) 的分析.
包括人口统计数据,程序数据和微生物学数据 (查,体液,伤口抹布).
对MDRO阳性SSI的MDRO频率和风险因素的评估.

主要成果:

494名患者中有138人 (27.9%) 呈MDRO阳性;61人从伤口中分离出MDRO.
多种药物耐药的肠道细菌 (58.1%) 和抗万科胺耐药的肠球菌 spp. (19.7%) 主要使用的是MDROs.
结直肠定居 (73.2%的MDRO携带患者) 是主要的风险因素 (OR 4.407),其次是术后的重症监护室停留 (OR 3.73).

结论:

使用MDROs的直肠殖民是腹部外科手术中SSI的重要危险因素.
建议将直肠定居状态纳入SSI预防中.
进一步的研究可能将重点放在基于殖民地位的有针对性的干预措施上.

关键词:

腹部外科手术腹部外科手术多种耐药生物多种耐药生物.结直肠殖民化的殖民化表面的手术部位感染.内脏外科手术是什么?内脏手术是什么?

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