Clinical Analysis Of The Bacterial Culture Of Postoperative Patients Abdominal Cavity Drainage-tube In Department Of Hepatobiliary Surgery

Objective1.To investigate the related risk factors of patients whose abdominaldrainage bacterial culture is positive after surgery in the department ofhepatobiliary surgery; and to explore the relationships between these riskfactors and the bacterial culture positive and coping strategies about thepositive patients;2.To know the bacteria spectrum of the abdominal drainage bacterialculture with postoperative patients in the department of hepatobiliary andits drug susceptibility.MethodsCollected the results of bacterial culture and drug susceptibility test ofabdominal drainage,which removalling after indwelling for more than3days since the operation treatment between June and December2014inthe department of hepatobiliary surgery of the first Hospital of JilinUniversity; then collect the irrelated risk factors which may influence theresults of bacteria cultured including:preoperative factors (gender, age,serum albumin level, fasting blood glucose, liver function, blood routine),surgical operation (operation, cleanliness factor, time of operation), and postoperative factors(drainage time) for univariate and multivariateanalysis.Simultaneously,analyse the bacterial spectrum and drug sensitivity ofthe bacteria, and investigate the necessity and the rationality of antibioticapplication after operation of the department of hepatobiliary surgery.ResultsIn the total of209samples,85cases havepositive results, the totalpositive rate was40.67%;ther analysis of risk factors showed that thepostoperative indwelling time of drainagetube,postoperative serumalbumin level, cleanliness factor, preoperative blood RBC level,preoperative AST level and preoperative serum albumin level had asignificant correlation with the positive results of peritoneal drainage tubeculture.In the85cases of positive strains obtained,43strains weregrampositive strains,accounting for50.59%;gram-negative strains were40strains,accounting for47.06%;the other two strains wereC.glabrata.Thetop sixbacteria detected were19strains of coagulase-negative staphylococcal,13strains of Escherichia coli,10strains of Klebsiellapneumoniae,8strains of Staphylococcus aureus,7strains of Enterococcus faecium and5strains of Bauman acinetobacter.Strains cultured mostly weremulti-drug-resistance.Gram-positive cocci were highlysensitive tovancomycin, teicoplanin, and non-sensitive tocephalosporins; gram-ne gativebacilli to imipenem, meropenem presented higlyh sensitivity, and low sensitivity to cephalosporins.ConclusionThe positive results of bacteriacultured magnified apparentgrowth ofbacteria in abdominal cavity,these bacteriaclosely related tointra-abdominal infection.Risk factors of positive results of bacterialculturedwere also the risk factors of postoperative intra-abdominalinfections,during peri-operation periodtakingsome preventivemeasuresfor these risk factorsto prevent the growth of bacteria in theabdominal cavity is essential.At the same time, combined withthe bacteria spectrum of abdominaldrainage tube,we can find it that for most of multi-drug-resistant bacteria,antibiotics was ineffective; when abdominal infection cases occurred, weneed to take comprehensive treatment measures.