Liang Caixia, Lu Yanping, Luo Xiajie, Weng Fengchai
Department of Geriatrics, Taizhou Hospital of Zhejiang Province, Taizhou, Zhejiang Province, 318050, People's Republic of China.
Department of Geriatric Rehabilitation, Taizhou Rehabilitation Hospital, Taizhou, Zhejiang Province, 318050, People's Republic of China.
Infect Drug Resist. 2024 Aug 12;17:3507-3517. doi: 10.2147/IDR.S474453. eCollection 2024.
Gestational Diabetes Mellitus (GDM) significantly increases the risk of adverse pregnancy outcomes, including elective pre-labor cesarean deliveries. Postoperative surgical site infections (SSIs) pose a significant concern, underscoring the need for a detailed investigation into their causes and preventative measures. The aim of this study is to systematically identify and analyze the microbial etiology and antimicrobial resistance profiles of pathogens responsible for SSIs in GDM patients undergoing elective pre-labor cesarean deliveries. Additionally, this research aims to elucidate the risk factors contributing to SSIs, with a specific focus on operation duration, amniotic fluid contamination, and genital tract inflammation, and their correlation with the incidence of SSIs.
A retrospective analysis was conducted at our Hospital between September 2018 and July 2023, involving 150 GDM patients who underwent elective pre-labor cesarean deliveries. Patients were categorized into infected and uninfected groups based on postoperative SSIs. Clinical data were meticulously collected and analyzed using SPSS software (version 27.0). Independent sample t-tests and chi-square tests were employed for statistical analysis.
Microbial profiling revealed that Gram-negative bacteria, primarily E. coli, constituted approximately 59.46% of the isolated strains, exhibiting significant resistance to commonly used antibiotics such as ampicillin and cefotaxime. Elevated levels of biomarkers, including Procalcitonin (PCT) and Hemoglobin A1c (HbA1c), were significantly associated with SSIs. Multivariate logistic regression analysis identified operation time ≥1-hour, amniotic fluid contamination, and genital tract inflammation as significant risk factors.
This study highlights the microbial etiology, resistance patterns, and risk factors for SSIs in GDM cesarean patients, emphasizing the need for tailored preoperative evaluations.
妊娠期糖尿病（GDM）显著增加了不良妊娠结局的风险，包括择期剖宫产。术后手术部位感染（SSI）是一个重大问题，凸显了详细调查其原因和预防措施的必要性。本研究的目的是系统地识别和分析接受择期剖宫产的GDM患者发生SSI的病原体的微生物病因和抗菌药物耐药谱。此外，本研究旨在阐明导致SSI的危险因素，特别关注手术时间、羊水污染和生殖道炎症，以及它们与SSI发生率的相关性。
2018年9月至2023年7月在我院进行了一项回顾性分析，纳入150例接受择期剖宫产的GDM患者。根据术后SSI将患者分为感染组和未感染组。使用SPSS软件（版本27.0）精心收集和分析临床数据。采用独立样本t检验和卡方检验进行统计分析。
微生物分析显示，革兰氏阴性菌，主要是大肠杆菌，约占分离菌株的59.46%，对氨苄西林和头孢噻肟等常用抗生素表现出显著耐药性。生物标志物水平升高，包括降钙素原（PCT）和糖化血红蛋白（HbA1c），与SSI显著相关。多因素逻辑回归分析确定手术时间≥1小时、羊水污染和生殖道炎症为显著危险因素。
本研究强调了GDM剖宫产患者SSI的微生物病因、耐药模式和危险因素，强调了进行针对性术前评估的必要性。
