肛周脓肿患者术后金黄色葡萄球菌致创面感染严重程度的影响因素分析OA
Analysis of influencing factors on the severity of wound infection caused by Staphylococcus aureus in patients with perianal abscess after surgery
目的 探讨肛周脓肿患者术后金黄色葡萄球菌致创面感染严重程度的影响因素.方法 选取2022年1月至2024年7月该院收治的156例肛周脓肿患者作为研究对象,根据创面感染严重程度将肛周脓肿患者分为轻度组(82例)与重度组(74例).收集所有患者基线资料.采用实时荧光定量聚合酶链反应检测金黄色葡萄球菌的毒力基因与耐药基因;采用多因素Logistic回归分析肛周脓肿患者术后创面重度感染的影响因素.结果 重度组高位脓肿患者比例、合并糖尿病患者比例及红细胞沉降率均高于轻度组,差异均有统计学意义(P＜0.05).156例肛周脓肿术后切口感染患者共检出156株金黄色葡萄球菌,其中轻度组检出80株,占比51.28％,重度组检出76株,占比48.72％.重度组毒力基因psmα、pvl及耐药基因mecA、Tet检出率均高于轻度组,差异均有统计学意义(P＜0.05).金黄色葡萄球菌对头孢唑啉、红霉素耐药率较高,对万古霉素和替拉考宁敏感.多因素Logistic回归分析结果显示,高位脓肿、合并糖尿病、毒力基因psmα与pvl、耐药基因mecA与Tet均为肛周脓肿患者术后创面重度感染的独立危险因素(P＜0.05).结论 肛周脓肿患者术后感染程度与脓肿位置、合并糖尿病、切口数量均相关,创面存在金黄色葡萄球菌分布且毒力基因和耐药基因检出率较高,临床可根据其合理用药,降低术后感染.
Objective To investigate the influencing factors of the severity of wound infection caused by Staphylococcus aureus in patients with perianal abscess after surgery.Methods A total of 156 patients with perianal abscess admitted to the hospital from January 2022 to July 2024 were selected as the research objects.According to the severity of wound infection,the patients with perianal abscess were divided into mild group(82 cases)and severe group(74 cases).Baseline data of all patients were collected.Real-time fluorescence quantitative polymerase chain reaction was used to detect the virulence genes and drug resistance genes of Staphylococcus aureus.Multivariate Logistic regression was used to analyze the influencing factors of severe postoperative wound infection in patients with perianal abscess.Results The proportion of patients with high abscess,the proportion of patients with diabetes and the erythrocyte sedimentation rate in the severe group were higher than those in the mild group,and the differences were statistically significant(P＜0.05).A total of 156 strains of Staphylococcus aureus were detected in 156 patients with perianal abscess postoperative inci-sion infection,of which 80 strains were detected in the mild group,accounting for 51.28％,and 76 strains were detected in the severe group,accounting for 48.72％.The detection rates of virulence genes psmα and pul and drug resistance genes mecA and Tet in the severe group were higher than those in the mild group,and the differences were statistically significant(P＜0.05).Staphylococcus aureus had a high resistance rate to Ce-fazolin and Erythromycin,and was sensitive to Vancomycin and Tiraconine.Multivariate Logistic regression a-nalysis showed that high abscess,diabetes mellitus,virulence genes psmα and pvl,drug resistance genes mecA and Tet were all independent risk factors for severe wound infection in patients with perianal abscess after surgery(P＜0.05).Conclusion The degree of postoperative infection in patients with perianal abscess is re-lated to the location of abscess,diabetes,and the number of incisions.There is Staphylococcus aureus distribu-tion in the wound,and the detection rate of virulence genes and drug resistance genes is high.Clinical rational drug use can reduce postoperative infection according to the results.
李彦娜;刘育虎;李洪;孙兴伟
陕西省西安市中医医院肛肠科,陕西西安 710000陕西省西安市中医医院肛肠科,陕西西安 710000陕西省西安市中医医院肛肠科,陕西西安 710000陕西省西安市中医医院肛肠科,陕西西安 710000
医药卫生
肛周脓肿创面感染金黄色葡萄球菌毒力基因耐药基因危险因素
perianal abscesswound infectionStaphylococcus aureusvirulence genedrug resist-ance generisk factor
《检验医学与临床》 2026 (17)
2352-2358,7
陕西省重点研发计划项目(2022SF-369).
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