Analysis of the risk factors, pathogenic bacteria and drug resistance of postoperative infection in patients with colorectal cancer / 新乡医学院学报

ABSTRACT

Objective To analyze the risk factors for postoperative infection of patients with colorectal cancer,and to investigate the distribution of pathogenic bacteria and drug resistance.Methods A total of 300 patients with colorectal cancer who underwent operation were selected from June 2013 to June 2017 in the Central Hospital of Tongchuan Mining Bureau,and the patients were divided into the infection group and the non-infection group according to the postoperative infection.The clinical data were compared between the two groups,and the risk factors for postoperative infection in colorectal cancer patients were analyzed by logistic regression.The total automatic bacterial culture apparatus was used for bacterial culture,and the drug sensitivity test was carried out by Kirby-Bauer.Results Among the 300 colorectal cancer patients,there were 61 cases of incision infection (infection group) and 239 cases without incision infection (non-infection group) after operation,the postoperative infection rate was 20.33％ (61/300).There were significant differences in the operation method,red blood cell counts,the levels of albumin,prealbumin and hemoglobin between the two groups (P ＜ 0.05);but there was no significant difference in sex,age,body mass index,diabetes mellitus history,abdominal surgery history,smoking history,drinking history,operation time,intraoperative bleeding volume,hospitalization time,indwelling time of urethral catheter,white blood cells and C-reactive protein levels between the two groups(P ＞ 0.05).Multiple factor logistic regression analysis showed that the decrease of albumin and prealbumin level was the independent risk factor for postoperative infection in patients with colorectal cancer (P ＜0.05).A total of 52 strains of pathogenic bacteria were detected in 61 cases of colorectal cancer combined with postoperative infection,including 38 strains of gram negative bacteria (73.08％),10 strains of gram positive bacteria (19.23％) and 4 strains of fungi (7.69％).Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa had high drug resistance to ampicillin,cefaclor,ceftriaxone,ceftizoxime,cefepime,cefoperazone,ceftazidime and ofloxacin;but they had low drug resistance to piperacillin,imipenem and amikacin.Conclusion The incidence of postoperative infection in patients with colorectal cancer is higher,the decrease of albumin and prealbumin is the independent risk factor for postoperative infection in patients with colorectal cancer.Gram-negative bacteria are the main pathogens of postoperative infection in patients with colorectal cancer and have high resistance to common antibiotics.