老年女性子宫切除术后阴道病原菌分布特征及药敏结果分析

doi:10.3969/j.issn.1003-9198.2024.12.008

Abstract

Abstract: Objective To analyze the distribution of vaginal pathogens and drug resistance in the elderly women after hysterectomy, and to provide a reference for the reasonable selection of perioperative antibiotics. Methods A retrospective analysis was conducted on the clinical data of 347cases of elderly women admitted to Women’s Hospital of Nanjing Medical University from January to December 2022 who underwent hysterectomy and received the detection of postoperative vaginal secretion culture. The clinical characteristics, postoperative infection indicators, distribution of vaginal pathogens and drug resistance results were analyzed. Results There were more gram-negative bacteria than gram-positive bacteria detected in the vagina of the elderly women after hysterectomy, among which Escherichia coli (34.21%) was the most, followed by Enterococcus faecalis (28.42%) and Klebsiella pneumoniae (5.26%).There was no significant difference in the distribution of vaginal pathogens in the patients with different age, operation methods and diseases, but there was significant difference in the distribution of vaginal pathogens in the patients with different hysterectomy ranges (P<0.05).Moreover, postoperative fever was more common in gram-negative bacteria group.The results of drug sensitivity showed that more than 60.00% of Escherichia coli and Klebsiella pneumoniae were resistant to cephalosporins and penicillins, while the resistance rate of β-lactam/β-lactamase inhibitor complex was less than 5%, and no resistance to carbapenem was found.The total multiple drug resistance rate of vaginal pathogens in the elderly women after hysterectomy was 80.00% (140/175). Conclusions Gram-negative bacteria are more easily detected in the vagina of elderly women after hysterectomy, and Escherichia coli is the most easily detected. The total multiple drug resistance rate of pathogenic bacteria is high.When upgrading the use of antibiotics in elderly women after hysterectomy, β-Lactam/β-Lactamase inhibitor complex is recommended, and the direct use of carbapenems should be avoided as much as possible.

Key words: pathogens, hysterectomy, aged, antimicrobial resistance

CLC Number:

R 619.3

ZHOU Lin, XIONG Keqin, LUAN Ting. Distribution and drug resistance of vaginal pathogens in elderly women after hysterectomy[J]. Practical Geriatrics, 2024, 38(12): 1224-1228.

References

[1] Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing[S]. Twenty-Seventh Informational Supplement, 2017, M100S, 27th Edition.
[2] RONGHE V, MODAK A, GOMASE K, et al. From prevention to management: understanding postoperative infections in gynaecology[J]. Cureus, 2023, 15(10):e46319.
[3] AHABWE O M, KABANDA T, ABESIGA L, et al. Bacterial isolates and antibiotic susceptibility among women with abnormal vaginal discharge attending the gynecology clinic at a tertiary hospital in southwestern Uganda: a cross-sectional study[J]. BMC Womens Health, 2023, 23(1):572.
[4] BROCARD E, REVEIZ L, RÉGNAUX J P, et al. Antibiotic prophylaxis for surgical procedures: a scoping review[J]. Rev Panam Salud Publica, 2021, 45:e62.
[5] ISKANDAR K, MURUGAIYAN J, HAMMOUDI HALAT D, et al. Antibiotic discovery and resistance: the chase and the race[J]. Antibiotics: Basel, 2022, 11(2):182.
[6] Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis[J]. Lancet, 2022, 399(10325):629-655.
[7] ALI A, GEBRETSADIK D, DESTA K. Incidence of surgical site infection, bacterial isolate, and their antimicrobial susceptibility pattern among patients who underwent surgery at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia[J]. SAGE Open Med, 2023, 11:20503121231172345.
[8] LUO H, XU L, CHEN Y. Drug resistance and susceptibility of amikacin in children with extended-spectrum beta-lactamase-producing Enterobacterales: a systematic review with meta-analysis[J]. Diagn Microbiol Infect Dis, 2023, 106(4):115956.
[9] CIMEN C, BERENDS M S, BATHOORN E, et al.Vancomycin-resistant enterococci (VRE) in hospital settings across European borders: a scoping review comparing the epidemiology in the Netherlands and Germany[J]. Antimicrob Resist Infect Control, 2023, 12(1):78.
[10] REINSETH I S, OVCHINNIKOV K V, TØNNESEN H H, et al. The increasing issue of vancomycin-resistant enterococci and the bacteriocin solution[J]. Probiotics Antimicrob Proteins, 2020, 12(3):1203-1217.

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Distribution and drug resistance of vaginal pathogens in elderly women after hysterectomy

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