Analysis Of Influencing Factors And Bacterial Species Of Incision Infection After Gastrointestinal Surgery

Objective To explore the related factors of incision infection after gastrointestinal surgery and analyze the types of infected bacteria.Methods To collect the clinical data(including gender,age,operation method and length)of 445 patients with gastrointestinal surgery admitted to the second affiliated hospital of Anhui medical university from November 2018 to November 2020;The subjects were divided into the following groups according to the following criteria: age、sex、surgical site(stomach,intestinal tract)、surgical duration(≥3 hours,<3 hours),etc.Observation indicators: 1.Sex、age、length of operation site,etc.2.Incidence of incision infection and types of infected bacteria.The measurement data of normal distribution is expressed by ?x±S,and counting data is expressed by composition ratio.the difference is statistically significant with P < 0.05.Results(1)There were 51 patients with incision infection。Compared with non-infected patients,there were 19 males and 32 females.17 cases were over 60 years old and 34 cases were under 60 years old.There were 14 cases with BMI < 25 kg/m2 and 37 cases with BMI ≥25kg/m2.There were 27 cases with diabetes,31 cases with hypoalbuminemia,14 cases with anemia and 20 cases with hypertension.There were 19 cases of emergency patients and 32 cases of non-emergency patients.There were 21 cases of laparoscopic surgery and 30 cases of laparotomy,21 cases of operation duration ≥3hours and 30 cases of operation duration < 3 hours,13 cases of operation site in stomach and intestinal tract respectively.There were 35 cases who used antibiotics preventively before operation,and 16 cases who did not use antibiotics.27 cases were prepared for intestinal tract before operation,while 24 cases were not.The differences were statistically significant.(2)Surgical patients with wound infection were cultured with wound exudate,among which 26 cases were Escherichia coli,accounting for50.98%.There were 4 cases of Proteus,accounting for 7.84%.There were 7 cases of Pseudomonas aeruginosa,accounting for 13.73%.There were 5 cases of Staphylococcus aureus,accounting for 9.80%.There were 5 cases of Staphylococcus epidermidis,accounting for 9.80%.Other 4 cases,accounting for 7.84%.Conclusion(1)The infection rate of gastrointestinal incision is related to gender,age,BMI index,basic diseases,operation type,operation mode,operation site,antibiotic use and intestinal preparation.That is,female,age over 60 years old,BMI over 28,emergency surgery,laparotomy,intestinal surgery,no antibiotics and no intestinal preparation are the high risk factors of incision infection after gastrointestinal surgery,which should be intervened.(2)Gram-negative bacteria are mainly Escherichia coli,gram-positive bacteria are mainly Staphylococcus,and common bacteria sensitive antibiotics are cefoperazone,ceftazidime,imipenem,vancomycin,linezolid and so on.Penicillin,ciprofloxacin,gentamicin tablets and ceftriaxone were resistant to antibiotics.The sensitive antibiotics of Escherichia coli are cefoperazone and ceftazidime.The sensitive antibiotics of staphylococcus are vancomycin and linezolid.