中国实用外科杂志

中国实用外科杂志

• 专题笔谈 • 上一篇    下一篇

外科感染细菌耐药特点与抗感染药物选择

俞云松，杜小幸   

  1. 浙江大学医学院附属邵逸夫医院感染科，浙江杭州 310016
  • 出版日期:2016-02-01 发布日期:2016-01-29

  • Online:2016-02-01 Published:2016-01-29

摘要：

手术部位感染包括手术切口感染和手术隐窝感染。流行病学调查发现，手术切口感染分离菌存在多样性，包括耐甲氧西林金黄色葡萄球菌和多重耐药革兰阴性菌等；而腹腔手术后的腹腔感染病原菌以肠道内源性细菌为主，产超广谱β-内酰胺酶肠杆菌科细菌和碳青霉烯耐药革兰阴性菌引起的感染须引起足够重视。而对于上述多重耐药菌株的感染须根据体外药敏、感染部位、病情严重程度以及药代动力学和药效动力学特点等选择合适的抗感染治疗方案。

关键词: 手术部位感染, 细菌耐药, 多重耐药菌, 抗菌治疗

Abstract:

Characteristics of the bacterial resistance and option of antibiotics in surgical infections        YU Yun-song，DU Xiao-xing. Department of Infectious Diseases，Sir Run Run Shaw Hospital，School of Medicine，Zhejiang University，Hangzhou 310016，China
Corresponding author：YU Yun-song，E-mail：yvys119@163.com
Abstract    Surgical site infections include incision infection and post-operative crypt infection. Epidemiological survey has revealed the bacteria diversity of incision infection pathogens，including MRSA and multidrug-resistant gram-negative bacteria. The intra-abdominal infections are caused by gut-derived bacteria. Of those bacteria, the roles of enterobacteriaceae spp. producing ESBLs or carbapenem-resistant gram-negative bacteria in the surgical site infection should raise many concerns. The appropriate anti-infection therapy of surgical site infection due to multidrug-resistant bacteria should be made according to drug susceptibility, infection site，severity，antibiotic pharmacokinetics and pharmacodynamics.

Key words: surgical site infection, bacterial resistance, multiple-drug resistance bacteria, antibacterial treatment