Research On The Application Of Vaginal Colonization Bacteria Identification In Prevention And Treatment Of Gynecological Infections

Part Ⅰ Analysis of the pathogenic bacteria species causing clinical infection in obstetrics and gynecology patientsObjectiveTo reveal the distribution and antibiotics resistance of pathogenic bacteria species causing obstetrical and gynecological infection and to provide reference for clinical therapy.MethodsThe bacteria species isolated from patients with obstetrical and gynecological infection from January 2008 to December 2015 and those with refractory vaginitis from January 2008 to December 2016 were investigated.The distribution of pathogenic bacteria species,multidrug resistant bacteria species and their resistance to antibiotics were counted.Data was analyzed using SPSS 19.0 statistical software.ResultsIn common obstetrics and gynecology related infections related to female genital tract bacteria,the common infectious bacteria species are Enterococcus faecalis and Escherichia coli,and the proportion of multidrug-resistant bacteria is high.High resistance rates to most common antibiotics such as penicillins,second-generation cephalosporins,and gentamicin,and low resistance to broad-spectrum antibiotics such as carbapenems,glycopeptides,etc.However,there are already resistant strains.ConclusionBefore the drug susceptibility results are reported,the experience recommends the use of antibiotics as follows:Treatment of vaginal infections Recommended use of ciprofloxacin for the treatment of genital purulent infections and surgical site infections piperacillin tazobactam or cefoperazone sulbactam is recommended.The reason for the ineffective treatment of obstinate vaginitis is the infection of vaginal resistant bacteria and the poor efficacy of systemic administration.The development of vaginal application of sensitive antibiotics may be the solution to this problem.Part Ⅱ Analysis on the species and antibiotics resistance of vaginal colonization bacteria in gynecological patientsObjectiveTo investigate the distribution and antibiotics resistance of vaginal colonization bacteria in gynecological patients,and to provide reference for clinical treatment.MethodsA total of 575 patients hospitalized in the gynecological ward of Nanfang Hospital from January 2016 to December 2017 were selected and the vaginal secretion samples were taken for bacterial culture and antibiotics susceptibility test.The distribution of dominant bacteria and multidrug resistant bacteria species,and their resistance to antibiotics was counted.Data was analyzed using SPSS 19.0 statistical software.ResultsStreptococcus and enterococcus faecalis were the most commonly detected genus and species.Multi-drug resistant bacteria accounted for 20.40%.Colonized bacteria had high resistance rates to aminoglycosides,second-generation cephalosporins,clindamycin,erythromycin and other antibiotics,and showed low resistance to broad-spectrum antibiotics such as carbapenems and glycopeptides.There was no significant difference in the detection rate of vaginal colonization and multi-drug resistant bacteria between the types of diseases,the history of pregnancy or childbirth,and contraceptive methods.ConclusionMulti-drug-resistant bacteria accounted for the high proportion in vaginal colonization bacteria.The second-generation cephalosporin recommended for the prevention of antibiotic use in gynecological surgery has a high resistance rate.The use of second-generation cephalosporins in experience can not effectively prevent perioperative infection such as hysterectomy.Part Ⅲ Relationship between antibiotic resistance of vaginal flora and infection after hysterectomyObjectiveTo investigate the effect of vaginal colonization screening and individualized prophylactic antibiotics on the infection after hysterectomy.MethodsPatients who underwent hysterectomy or radical hysterectomy in January 2016 to December 2017 were recruited.Cases that received vaginal colonization screening and individualized prophylactic antibiotics were assigned to the experimental group.The remaining patients were set to control groups.The incidence of surgical site infection was calculated.SPSS 19.0 statistical software was used for data analysis.ResultsThe infection of the surgical site of laparotomy was mainly abdominal incision infection,and the infection of the surgical site of vaginal and laparoscopic surgery was mainly organ/cavity infection.Except for radical hysterectomy,the incidence of surgical site infection in the experimental group was lower than that in the control group.ConclusionBefore the implementation of hysterectomy,the combination of vaginal secretions and bacterial culture sensitivity test,and timely replacement of sensitive antibiotics based on the results,can effectively reduce the complications of hysterectomy perioperative infection.