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非手术腭裂软腭 4 年间微生物污染状况变化分析

Microbial contamination profile change over a 4-year period in nonoperated cleft soft palate.

机构信息

Department of Anatomy, University of Pretoria, Arcadia, South Africa.

Maxillo-Facial and Oral Surgical Practice, Life-Wilgers Hospital, Lynnwood Ridge, South Africa.

出版信息

J Appl Microbiol. 2022 Jan;132(1):665-674. doi: 10.1111/jam.15193. Epub 2021 Jul 29.

Abstract

AIMS

Surgical site infection is a major concern in cleft soft palate. Knowledge of the type, number and antimicrobial resistance of pathogens present preoperatively contribute to treatment success. The aim of this study is to determine whether or not the microbial contamination (diversity) preoperatively has changed since 2015.

METHODS AND RESULTS

Swabs were taken from the surgical site in 103 consecutive patients who presented for primary repair of the soft palate cleft. These were sent for microscopy, culture and sensitivity testing. Swabs were taken before disinfecting the site. Results were tabled and compared with two previous studies from the same facility. Out of 103 patients, 100 patients showed positive cultures with 42 different pathogenic micro-organisms identified. Most dominant pathogen was Klebsiella pneumoniae, 45.6%, increased by 28% from the previous two studies, with 93.6% of these pathogens resistant to one or more antimicrobials. Most of the other identified pathogens showed an alarming increase in occurrence, with a wide resistance to antimicrobials.

CONCLUSIONS

The increase in number and diversity of microbial contamination as well as their resistance to antimicrobials is a real concern. Ways of preventing postoperative infection in a natural way need to be explored.

SIGNIFICANCE

Surgeons need to be aware of constant changes in micro-organisms.

摘要

目的

手术部位感染是腭裂软腭的主要关注点。了解术前存在的病原体的类型、数量和抗菌药物耐药性有助于治疗成功。本研究旨在确定自 2015 年以来,术前微生物污染(多样性)是否发生了变化。

方法和结果

连续 103 例接受腭裂软腭初次修复的患者在手术部位采集拭子。对这些拭子进行显微镜检查、培养和药敏试验。在消毒手术部位之前采集拭子。将结果制成表格,并与同一机构的两项先前研究进行比较。103 例患者中,100 例培养阳性,鉴定出 42 种不同的致病微生物。最主要的病原体是肺炎克雷伯菌,占 45.6%,比前两项研究增加了 28%,其中 93.6%的病原体对一种或多种抗菌药物耐药。其他大多数已识别病原体的出现频率明显增加,对抗菌药物的耐药性也很强。

结论

微生物污染数量和多样性的增加以及它们对抗菌药物的耐药性令人担忧。需要探索以自然方式预防术后感染的方法。

意义

外科医生需要意识到微生物的不断变化。

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