烧伤患者细菌学调查及耐药性分析  

Investigation on bacterial flora and analysis of their antibiotic resistance from burn patients

作　　者：魏迪南[1] 刘军[1] 

机构地区：[1]昆明医学院第二附属医院烧伤科,650101

出　　处：《中华烧伤杂志》2006年第2期92-95,共4页Chinese Journal of Burns

摘　　要：目的通过对烧伤患者的细菌学调查情况及耐药性进行分析,为临床治疗提供参考。方法从2002年1月-2004年12月笔者单位收治的烧伤患者创面、血、痰及尿液等标本中分离出 431株细菌,用纸片琼脂扩散法进行药物敏感试验,就其中数量较多的5种细菌进行回顾性分析。结果检出的细菌中革兰阴性(G-)杆菌占71％,革兰阳性(G+)球菌占29％。数量较多的5种细菌分别为:铜绿假单胞菌占36％,金黄色葡萄球菌占17％,大肠埃希菌占15％,阴沟肠杆菌占8％,表皮葡萄球菌占7％。铜绿假单胞菌占G-杆菌的50．7％,对大多数抗生素的耐药率>90．0％。金黄色葡萄球菌中甲氧西林耐药金黄色葡萄球菌(MRSA)的分离率为91．9％,仅对万古霉素敏感。阴沟肠杆菌的检出率与大肠埃希菌相似,对亚胺培南、头孢哌酮/舒巴坦敏感。耐药率较低的抗生素主要有万古霉素、头孢哌酮/舒巴坦和亚胺培南。结论笔者单位细菌感染仍以G-杆菌为主,细菌的耐药率高,可能与MRSA及β内酰胺酶的产生,特别是超广谱β内酰胺酶的大量产生有关。Objective To investigate the bacterial flora from burn patients and their antibiotic resistance in our department, so as to provide reference for clinical application in the treatment of burn patients. Methods Four hundred and thirty-one strains of bacteria were isolated from wounds, blood and urine specimens of the burn patients hospitalized in our department from January, 2002 to December, 2004, and among them 5 strains were analyzed. Disc agar dilution method was used for determination of drug sensitivity. Resuits Among all bacteria, Gram negative（G^- ） bacilli accounted for 71% , and Gram positive（ G^＋ ） cocci accounted for 29%. The five predominant bacteria from the wounds were Pseudomonas aeruginosa（36% ） , Staphylococcus aureus （ SA, 17% ） , Escherichia coli （ 15% ） , Aerobacter cloacae （ 8% ） , Staphylococcus epidermidis（ Se, 7% ）. Among all the G^- bacilli, Pseudomonas aeruginosa accounted for 50.7% , 90.0% of them were drug resistant, while Staphylococcus aureus accounted for 60% of all G^＋ cocci, and MRSA was identified in 91.9% of Staphylococcus aureus, which was only sensitive to Vancomycin. Aerobacter cloacae were sensitive to Imipenem and Cefoperazone/Sulbactam. In general, Vancomycin , Imipenem and Cefoperazone/Sulbactam were effective to the bacteria. Conclusion G^- bacilli were still dominant in our burn ward. The high antibiotic resistance may be related to the production of MRSA and β-lactamase, especially with a high incidence of ESBL producing bacteria.

关 键 词：烧伤 细菌 耐药性 

分 类 号：R644[医药卫生—外科学] R181.34[医药卫生—临床医学]