烧伤患者葡萄球菌医院感染临床与实验室研究  

Study of nosocomial infection of staphylococus in burn staphylococus patients

作　　者：刘晓红[1] 

机构地区：[1]临沂市人民医院检验中心,临沂276003

出　　处：《医学检验与临床》2006年第1期51-53,共3页Medical Laboratory Science and Clinics

摘　　要：目的为了防治在烧伤患者中由葡萄球菌引起的医院感染。方法北院烧伤科感染患者的创面分泌物、尿、痰、大便、血、工作人员手做细菌培养和体外药物敏感试验。方法对195株金黄色葡萄球菌和286株凝固酶阴性葡萄球菌用VITE-32和GPS 107药敏卡、GPI鉴定卡、APl-Spath手工条鉴定细菌并测定其对药物的敏感性。应用胶乳凝集试验检测青霉素结合蛋白2a(PBP2a),同时用NCCLS推荐的纸片扩散法检测耐甲氧西林的葡萄球菌、耐万占霉素的葡萄球菌(VRSA)。结果耐甲氧西林的金黄色葡萄球菌(MRSA)仪器法、青霉素结合蛋白2a(PBP2a)、纸片扩散法,阳性率分别72%、76%、68%,凝固酶阴性的葡萄球菌耐甲氧西林仪器法、纸片扩散法(CNS),分别是78%、72%,青霉素结合蛋白2a(PBP2a)全部阴性。未检出VRSA。结论万古霉素、复方新诺明和四环素对耐甲氧西林的葡萄球菌有较好的抗菌活性,胶乳凝集试验检测青霉素结合蛋白2a(PBP2a)简便、快速、准确结论感染的菌株以MRSA、MRCNR为主,且成多重耐药;创面的大小与烧伤的深度、三代头孢菌素和氟喹诺酮类抗生素的不合理应用及住院时间,是引起烧伤患者葡萄球菌感染的危险因素。Objective To control the nosocomial infection caused by meticillin-resistant-resistant staphylococcus in burn patients.Methods Right 195 staphylococcns aureus and 286 coagulase-negative staphylococcus use the VITEK 32 with the GPS-107 medicine card,GPI card,APl hand icraft IO settle the germs and measurese its to the medicine's sensitivity.Application latex the PBP2a to experiment the examination penicillin bind proten 2 aPBP2a),at the same time slip K-B that recommend with NCCLS the method examination resistant the methicillin.Result Surveillance for staphylococcusau reus with reduced susceptibility to vancomycin:Resistant the methicillin staphylococcus that staphylococcus aureusMRSA)instrument of gold method,penicillin bind pronten 2 asPBP2a),slip K-B the method,male rate distinguish 72%、76%、68%,coagulase-negative staphylococcus Resistant the methicillinCNS),respectively is 78%、72%,PBP2a all negative,but none possessed the heteroresistance phenlype on population analysis.Vancomycin MICs ranged from 1to2 ug/ml.Conclusion Staphylococcus that sensitive vancomycin、SMZ-TMP tetracyclin,Latex fixation tests is simple,fast and accurate for detection of MRSA and suitable for use in clinical laboratiories.Conclusions Staphylociccus may cause infections burnwound,urinary tract,resoir atorv tract,the alimentary canal and blood Most of them are MRSA and MRCNS and multidrug resistant.savere burn,abuse of third generation cephalosporins and fluoroqinlones and long hospital stay may be the risk factors fox staphyiococcal nosocomial infections.

关 键 词：烧伤 患者 金黄色葡萄球菌 医院感染 临床 实验室研究 耐甲氧西林 结合蛋白 纸片扩散法 青霉素 凝固酶阴性的葡萄球菌 凝固酶阴性葡萄球菌 体外药物敏感试验 试验检测 胶乳凝集 氟喹诺酮类抗生素 感染的危险因素 仪器法 三代头孢菌素 复方新诺明 

分 类 号：R644[医药卫生—外科学] R515[医药卫生—临床医学]