烧伤创面细菌学调查与烧伤感染抗生素经验性治疗的探讨  

Administration of antibiotics in the treatment of infection of burns based on bacteriological surveillance from burn wound and the analysis of bacterial resistance to antibiotics

作　　者：童仁联[1] 陈辉[1] 黄峻[1] 梁达荣[1] 

机构地区：[1]广东省广州市红十字会医院暨南大学第四附属医院烧伤整形科,广东广州510220

出　　处：《中国医师杂志》2006年第6期765-767,共3页Journal of Chinese Physician

摘　　要：目的探讨烧伤创面侵袭性感染早期经验性抗生素治疗方案。方法对1999～2004年间收治的581例烧伤病人的创面分泌物、焦痂的细菌培养及药物敏感试验结果进行回顾性分析总结。结果从581例病人创面分泌物及焦痂标本中检测出细菌887株，其中G^-杆菌481株，占54．23％，G^-菌406株，占45．77％。G^-杆菌中，铜绿假单孢菌居首位，其次是肠杆菌科。G^＋菌中，金黄色葡萄球菌居首位，其中，MRSA占71．48％。药敏试验显示，铜绿假单孢菌对奈替米星耐药率有下降的趋势，肠杆菌科对亚胺培南耐药率维持在较低水平，G^＋菌对万古霉素敏感。结论烧伤感染以G^-杆菌为主，细菌对常用的抗生素有多重耐药性，定期监测烧伤创面细菌菌种分布及耐药率变化，对烧伤感染早期经验性抗生素治疗有重要意义，是经验性选择抗生素的重要依据。Objective To investigate the administration of antibiotics in the treatment of infection of burns based on bacteriological surveillance from burn wound. Methods A retrospective analysis of bacterial culture and dmg-sensitivity results from burn wound and sub- eschar tissues in 581 patients during 1999 to 2004 was carried out. Results Eight hundred and eighty-seven strains of bacteria were isolated from burn wound and subeschar tissues in 581 patients, among which 481 strains were gram negative （54. 23% ）, and 406 strains were gram positive （45.77%）. Among the bacteria of gram negative, the most majority was Pseudomonas and then was the Enterobacteriaceae. Among the bacteria of gram positive, Staphylcoecus aureus was the majority, and MRSA accounted for 71.48% in the Staphylcoecus aureus. The re- sistance of Pseudomonas to Netilmicin was decreased from 20. 1% to 4. 9%, and the resistance of Enterobacteriaceae to Imipenem was still in a low level. All bacteria of gram positive were sensitive to Vancomycin. Conclusion The majority of the bacteria of burn infection is gram negative. The isolated bacteria show multiple resistance to antibiotic. The analysis of bacteria from burn wound and resistance of bacteria to antibiotic is very important to experiential treatment of antibiotic for burn infection.

关 键 词：烧伤/微生物学/药物疗法 细菌感染 抗菌药/治疗应用 心室功能 左 

分 类 号：R644[医药卫生—外科学]