Edwards G F, Lindsay G, Taylor E W
Falkirk and District Royal Infirmary.
J Hosp Infect. 1990 Oct;16(3):249-55. doi: 10.1016/0195-6701(90)90113-3.
A prospective audit of 644 patients undergoing biliary tract operations has been conducted in ten district general hospitals. All patients received a single dose of ampicillin 2 g and sulbactam 1 g as antibiotic prophylaxis. Bacteria were cultured from the bile of 121 patients. In patients with sterile bile the incidence of postoperative infection was 2.5%, while in those with colonized bile it was 22% (P less than 0.0001). The 35 patients from whose bile bacteria of two or more species were isolated, had a higher incidence of wound infection (34%) than those whose bile yielded only one species of bacterium (17%; P less than 0.05). Seventeen of the 27 patients with colonized bile who developed postoperative infection were shown to be infected by the same organisms that had been isolated from their bile. The patients whose bile yielded organisms resistant to the prophylactic antibiotic combination did not have a significantly higher rate of infection than those from whose bile only sensitive organisms were obtained. A marked difference in sensitivity patterns between the participating hospitals was observed.
在十家地区综合医院对644例接受胆道手术的患者进行了一项前瞻性审计。所有患者均接受单剂量2克氨苄西林和1克舒巴坦作为抗生素预防用药。从121例患者的胆汁中培养出细菌。胆汁无菌的患者术后感染发生率为2.5%，而胆汁有细菌定植的患者术后感染发生率为22%（P<0.0001）。胆汁中分离出两种或更多种细菌的35例患者，伤口感染发生率（34%）高于胆汁中仅培养出一种细菌的患者（17%；P<0.05）。27例胆汁有细菌定植且发生术后感染的患者中，有17例被证明感染的是从其胆汁中分离出的相同微生物。胆汁中培养出对预防性抗生素联合用药耐药的微生物的患者，其感染率并不显著高于胆汁中仅培养出敏感微生物的患者。观察到参与研究的医院之间在药敏模式上存在显著差异。
