Analysis of Pathogen Distribution, Drug Sensitivity and Influencing Factors of Postoperative Respiratory Tract Infections in Patients with Gastrointestinal Surgery
TU Xiu, ZHANG Kechang, WU Zhan
Chuzhou Hospital Affiliated to Anhui Medical University / Chuzhou First People's Hospital, Anhui Chuzhou 239057, China
Abstract：Objective: To investigate the distribution of pathogens, drug sensitivity, and influencing factors of postoperative respiratory tract infections in patients undergoing gastrointestinal surgery. Methods: A total of 105 patients with postoperative respiratory tract infections after gastrointestinal surgery from April 2019 to April 2023 were selected as the infection group. The distribution and drug sensitivity of pathogens in infected patients were analyzed. Another 105 patients who did not develop respiratory tract infections after gastrointestinal surgery during the same period were selected as the non-infection group. General information was collected for both groups, and multifactor logistic regression analysis was used to explore the risk factors for postoperative respiratory tract infections in patients undergoing gastrointestinal surgery. Results: In the 105 patients of the infection group, a total of 121 strains of pathogens were isolated from sputum samples. Among them, 78 strains (64.46%) were Gram-negative bacteria, mainly Pseudomonas aeruginosa; 37 strains (30.58%) were Gram-positive bacteria, mainly Staphylococcus aureus; and 6 strains (4.96%) were fungi, all Candida albicans. Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii had a 100% resistance rate to ampicillin. The resistance rates of Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli to piperacillin/tazobactam were 6.45%, 15.00%, and 7.69%, respectively. Staphylococcus aureus, hemolytic Staphylococcus, and Staphylococcus epidermidis had resistance rates of 100.00%, 90.00%, and 100.00% to penicillin, respectively. The resistance rates of Staphylococcus aureus, hemolytic Staphylococcus, and Staphylococcus epidermidis to quinupristin/dalfopristin were all 0.00%. There were statistically significant differences between the two groups in terms of age, smoking history, diabetes, history of lung disease, surgical method, surgical nature, surgical time, and gastric tube retention (P<0.05). Binary logistic regression analysis showed that smoking history (OR=1.772, p=0.002), diabetes (OR=2.212, P<0.001), history of lung disease (OR=1.950, P=0.001), open surgery (OR=2.522, P<0.001), emergency surgery (OR=2.389, P<0.001), surgery time ≥2h (OR=2.102, P=0.002), and gastric tube retention (OR=1.857, P<0.001) were all risk factors for postoperative respiratory tract infections in patients undergoing gastrointestinal surgery. Conclusion: Postoperative respiratory tract infections in patients undergoing gastrointestinal surgery are mainly caused by Gram-negative bacteria. Gram-negative bacteria have high resistance to ampicillin, and Gram-positive bacteria have high resistance to penicillin. The occurrence of postoperative respiratory tract infections is related to multiple risk factors.
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2023, Vol. 29 
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