摘要
目的研究普外科患者手术切口感染病原菌分布及血清白细胞介素-10(Interleukin-10,IL-10)、前列腺素E2(ProstaglandinE2,PGE2)、人可溶性细胞间黏附分子-1(Soluble intercellular adhesion molecul-1,sICAM-1)水平变化意义。方法选取2019年1月-2020年1月于淳安县第一人民医院普外科进行手术的患者1 569例为研究对象;采用回顾性调查的形式,收集患者基本资料;在无菌条件下,对患者切口分泌物培养标本伤口处渗液、呼吸道处的分泌物、导管尖端的物质以及尿液进行细菌培养,进行病原菌鉴定;比较患者IL-10、PGE2、sICAM-1。结果 1 569例普外科手术患者中,术后发生切口感染97例,切口感染率为6.18%;切口分泌物共培养分离病原菌103株,病原菌检出率为6.56%(103/1 569),其中革兰阴性菌68株占66.02%,以大肠埃希菌、铜绿假单胞菌为主,革兰阳性菌30株占29.13%,以金黄色葡萄球菌、粪肠球菌为主。切口感染组血清IL-10、PGE2、sICAM-1分别为(29.54±8.17)pg/ml、(3 692.56±267.54)pg/ml、(295.37±24.15)μg/L高于切口未感染组(P<0.001)。IL-10、PGE2蛋白之间呈现为正相关(r=0.204,P=0.045);IL-10、sICAM-1蛋白之间呈现为正相关(r=0.229,P=0.024);PGE2、sICAM-1蛋白之间呈现为正相关(r=0.418,P=0.001)。结论普外科手术切口感染患者最常见的病原菌为革兰阴性菌,与血清IL-10、PGE2、sICAM-1水平有关,这三项指标对预防和治疗普外科手术切口感染具有重要意义。
OBJECTIVE To study the distribution of pathogenic bacteria in surgical incision infection and the significance of changes in serum interleukin-10(IL-10), prostaglandin E2(PGE2), human soluble intercellular adhesion molecule-1(soluble intercellular adhesion molecul-1. sICAM-1) levels in general surgery patients. METHODS A total of 1 569 patients who underwent general surgery at the First People′s Hospital of Chun′an County from Jan. 2019 to Jan. 2020 were selected as the research subject;a retrospective investigation was used to collect basic patient data;under sterile conditions, the exudate from the incision, the secretion from the respiratory tract, the material at the tip of the catheter, and urine of patients were cultured for pathogen identification;the IL-10, PGE2, and sICAM-1 of patients were compared. RESULTS Among 1 569 general surgery patients, 97 cases had incision infection after operation, the infection rate was 6.18%;103 strains of pathogens were co-cultured and isolated from incision secretion, and the detection rate of pathogens was 6.56%(103/1 569), of which 68 strains of Gram-negative bacteria accounted for 66.02%, mainly Escherichia coli and Pseudomonas aeruginosa, 30 strains of Gram-positive bacteria accounted for 29.13%, mainly Staphylococcus aureus and Enterococcus faecalis. The serum levels of IL-10, PGE2 and sICAM-1 in the incision infection group were(29.54±8.17)pg/ml,(3 692.56±267.54)pg/ml and(295.37±24.15)μg/L, respectively, significantly higher than those in the non-infection group(P<0.001). There was a positive correlation between IL-10 and PGE2 protein(r=0.204, P=0.045), a positive correlation between IL-10 and sICAM-1 protein(r=0.229, P=0.024), and a positive correlation between PGE2 and sICAM-1 protein(r=0.418, P=0.001). CONCLUSION The most common pathogenic bacteria in patients with general surgical incision infection were G-negative aerobic bacteria, which was related to the levels of serum IL-10, PGE2 and sICAM-1, and the three indexes have great significance for the prevention and treatment of general surgical incision infection.
作者
郑元飞
刘晋
李云生
徐晓敏
陈安祥
ZHENG Yuan-fei;LIU Jin;LI Yun-sheng;XU Xiao-min;CHEN An-xiang(The First People's Hospital of Chun'an County,Hangzhou,Zhejiang 317000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第3期399-403,共5页
Chinese Journal of Nosocomiology
基金
浙江中医药大学校级科研基金资助项目(2018ZJ05)。
关键词
手术切口感染
病原菌
人可溶性细胞间黏附分子-1
Surgical incision infection
Pathogenic bacteria
Human soluble intercellular adhesion molecule 1
