Múñez Elena, Ramos Antonio, Espejo Teresa Álvarez de, Vaqué Josep, Sánchez-Payá José, Pastor Vicente, Asensio Angel
Servicio de Medicina Interna (Unidad de Infecciosas), Universidad Autónoma de Madrid, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain.
Cir Esp. 2011 Nov;89(9):606-12. doi: 10.1016/j.ciresp.2011.05.008. Epub 2011 Aug 5.
Knowledge of the microbiology of surgical infections after abdominal surgery can be of use when prescribing effective empirical antibiotic treatments.
Analysis of surgical infections after abdominal surgery in patients enrolled in the Prevalence of Infections in Spanish Hospitals (EPINE) corresponding to the years 1999-2006.
During the period of the study, 2,280 patients who were subjected to upper or lower abdominal tract surgery were diagnosed with an infection at the surgical site (SSI). Eight hundred and eighty three patients (37%) had an operation of the upper abdominal tract (gastric, hepatobiliary, and pancreatic surgery) and 1,447 patients (63%) lower abdominal tract surgery (appendectomy and colon surgery). A total of 2,617 bacterial species were isolated in the 2,280 patients included in the analysis. The most frequent microorganisms isolated were, Escherichia coli (28%), Enterococcus spp. (15%), Streptococcus spp. (8%), Pseudomonas aeruginosa (7%), and Staphylococcus aureus (5%, resistant to methicillin 2%). In the surgical infections after upper abdominal tract procedures, there were a higher proportion of isolations of staphylococci, Klebsiella pneumoniae, Enterobacter spp., Acinetobacter spp. and Candida albicans and less Escherichia coli, Bacteroides fragilis and Clostridium spp.
The microbiology of SSI produced after upper abdominal tract surgery did not show any significant differences compared to those of the lower tract. However, more cases of SSI were detected due to staphylococci, Klebsiella pneumoniae, Enterobacter spp., Acinetobacter spp. and Candida albicans and less caused by Escherichia coli, Bacteroides fragilis and Clostridium spp.
了解腹部手术后手术感染的微生物学情况,有助于开出有效的经验性抗生素治疗方案。
对纳入西班牙医院感染患病率(EPINE)研究的1999 - 2006年腹部手术后手术感染情况进行分析。
在研究期间,2280例接受上腹部或下腹部手术的患者被诊断为手术部位感染(SSI)。883例患者(37%)接受上腹部手术(胃、肝胆和胰腺手术),1447例患者(63%)接受下腹部手术(阑尾切除术和结肠手术)。在纳入分析的2280例患者中共分离出2617种细菌。最常分离出的微生物为大肠埃希菌(28%)、肠球菌属(15%)、链球菌属(8%)、铜绿假单胞菌(7%)和金黄色葡萄球菌(5%,耐甲氧西林的占2%)。在上腹部手术后的手术感染中,葡萄球菌、肺炎克雷伯菌、肠杆菌属、不动杆菌属和白色念珠菌的分离比例较高,而大肠埃希菌、脆弱拟杆菌和梭菌属的分离比例较低。
上腹部手术后发生的手术部位感染的微生物学情况与下腹部手术相比无显著差异。然而,由葡萄球菌、肺炎克雷伯菌、肠杆菌属、不动杆菌属和白色念珠菌引起的手术部位感染病例较多,而由大肠埃希菌、脆弱拟杆菌和梭菌属引起的病例较少。