异体输血患者术后感染情况和病原菌分布及耐药特征
Postoperative infection,pathogens distribution and drug resistance characteristics in patients undergoing allogeneic transfusion
朱卫金 1潘美珍 2朱培元3
作者信息
- 1. 常州市中医医院输血科,江苏常州 213003
- 2. 常州市中医医院检验科,江苏常州 213003
- 3. 南京市中医院输血科,江苏南京 210022
- 折叠
摘要
目的 分析异体输血患者术后感染情况、病原菌分布及耐药特征,以期指导临床合理使用抗生素.方法 回顾性收集2020年5月-2023年4月期间在常州市中医医院外科接受异体输血治疗的80例患者作为研究对象,统计患者术后感染情况,比较感染组(n=21)与未感染组(n=59)临床资料,分析术后感染患者的病原菌分布情况及耐药特征.结果 80例异体输血患者术后感染率为26.25％.感染组与未感染组在输血成分是否为红细胞、异体输血输注时机、异体输血输注量和红细胞成分储存时间比较上,差异均有统计学意义(x2=11.719、7.590、6.432、7.882,P均＜0.05).术后感染患者共分离出病原菌29株,主要为革兰阴性菌(大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌)(62.07％),革兰阳性菌(溶血葡萄球菌、表皮葡萄球菌)次之(31.03％),真菌最少(6.90％).大肠埃希菌和肺炎克雷伯菌对哌拉西林他唑巴坦、美罗培南几乎不耐药,对氨苄西林舒巴坦、头孢曲松耐药率相对较高.溶血葡萄球菌、表皮葡萄球菌对青霉素G、红霉素耐药率均较高,尤其是对青霉素G可达100％耐药,对利奈唑胺、万古霉素几乎不耐药.结论 异体输血患者术后感染率较高,以革兰阴性菌中大肠埃希菌最为常见,临床在未获取血培养及耐药性结果时,选择经验性抗生素治疗时需要综合考虑本院病原菌流行特点及耐药情况.
Abstract
Objective To analyze postoperative infection,pathogens distribution and drug resistance characteristics in patients undergoing allogeneic transfusion in order to guide clinical rational use of antibiotics.Methods A total of 80 patients undergoing allogeneic transfusion in the Surgery Department of the Changzhou Hospital of Traditional Chinese Medicine were retrospectively enrolled as the research objects between May 2020 and April 2023.The postoperative infection in patients was statistically analyzed.The clinical data in infection group(n=21)and non-infection group(n=59)were compared.The pathogens distribution and drug resistance characteristics in infection patients were analyzed.Results In the 80 patients after allogeneic transfusion,the incidence of infection was 26.25％.There were significant differences in erythrocytes transfusion,allogeneic transfusion timing,allogeneic transfusion volume and storage time of erythrocytes component between infection group and non-infection group(x2=11.719,7.590,6.432,7.882;all P＜0.05).In infection patients,there were 29 strains of pathogens,including Gram-negative bacteria(62.07％,including Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae),Gram-positive bacteria(31.03％,including Staphylococcus haemolyticus and Staphylococcus epidermidis)and fungi(6.90％).Escherichia coli and Klebsiella pneumoniae were almost not resistant to piperacillin/tazobactam or meropenem,and their resistance rates to ampicillin sulbactam and ceftriaxone were relatively higher.The resistance rates of Staphylococcus hemolyticus and Staphylococcus epidermidis were relatively higher to penicillin G and erythromycin,especially to penicillin G(100％),but they were almost not resistant to linezolid and vancomycin.Conclusions The incidence of postoperative infection was high in patients undergoing allogeneic transfusion,and Escherichia coli was the most common in Gram-negative bacteria.In clinical practice,it should be necessary to comprehensively consider epidemic characteristics and drug resistance of pathogens in the hospital when selecting empirical antibacterial therapy if there were no blood culture and drug resistance results.
关键词
异体输血/术后感染/病原菌/耐药特征Key words
Allogeneic transfusion/Postoperative infection/Pathogen/Drug resistance characteristic引用本文复制引用
基金项目
江苏省输血协会英科新创科研基金(JS2022006)
出版年
2024
NETL
NSTL
万方数据