烧伤早期创面细菌菌种分布和耐药性监测  

Resistance of the predominant bacterial strains on burn wound during early postburn stage

作　　者：赵遵江[1] 薛忠信[2] 黄新明[1] 张保德[2] 章荣涛[2] 

机构地区：[1]安徽医科大学2004级,在职硕士研究生安徽合肥230001 [2]安徽医科大学第五临床学院六安市人民医院,安徽六安237005

出　　处：《医学信息（西安上半月）》2006年第7期1200-1203,共4页Medical Information

摘　　要：目的 对烧伤早期创面细菌菌种分布和耐药性进行分析，为临床用药提供参考。方法 选用245例烧伤患者伤后早期创面细菌培养、鉴定细菌菌株并进行药物敏感试验。结果 245份标本中237份阳性，检出细菌139株，其中革兰阴性杆菌71株，革兰阳性球菌68株；金黄色葡萄球菌32株，凝固酶阴性葡萄球菌28株，铜绿假单胞菌27株，大肠埃希菌12株，肠杆菌属11株，肠球菌属9株，真菌4株，其他细菌16株。金黄色葡萄球菌对青霉素、氨苄青霉素、笨唑青霉素钠、环丙沙星、复方新诺明、万古霉素耐药率分别为89％、80％、38％、39％、6％、0％，革兰阳性球菌株对青霉素、氨苄青霉素、笨唑青霉素钠、环丙沙星、复方新诺明耐药率在6％～89％之间，未发现对万古霉素耐药菌株。铜绿假单胞菌对阿米卡星、头孢派酮／舒巴坦、头孢他定、亚胺培南、妥布霉素耐药率分别为18％、8％、18％、11％、14％，革兰阴性杆菌株对阿米卡星、头孢派酮／舒巴坦、头孢他定、亚胺培南、妥布霉素耐药率在8％～18％之间。结论 目前烧伤早期创面细菌菌种以金黄色葡萄球菌和凝固酶阴性葡萄球菌为主，铜绿假单胞菌次之；且这些细菌耐药性明显升高，另外肠球菌和真菌也有所增加。提示在烧伤早期应正确使用抗生素，不宜滥用广谱抗生素。Objective To investigate the resistance of the predominant bacterial strains on burn wound during early postburn benod in recent 4 years proridng the thformutim for climtal medmice. Methods： 245 cases of severely burned patients during early post-burn stage were harvested for the determinstions of bacteris and their resistance to antibiotics with routine methods. Results： 237 samples out of 245 were postive culture. 139 stains of bacteria were cultured,the Gram negative bacilli were 71 stains, the G ＋ cocci were 68 stains,in which 32 stains were S. aureus,28 Staphylococcus with negative coagulase,27 Pseudomonas aeruginosa,12 Escherichia coli, 11 Enterobacter, 9enterococci,4 fungiand 16 other bacteria. The resistance of S. aureus to penicillin, ampicillin, oxacillin, amikacin, trimethoprim/Sulfamethoxaz, vancomycin was 89% .80%. 38%. 39% .6% and 0%, The resistance of the G＋ cocci were between 6% and 89% . The resistance of pseudomonas aeruginosa to ciprofioxacin, ceftazidine/sulbactam, imipenem, tobramycin was 18% .8% . 18%. 110% and 14%, The resistance of the Gram negative bacilli were between 8% and 18% . Conclusions：The results suggested that Staphylococcus with negative coagulase and S. aureus were the predominant bacteria and Pseudomonas aeruginosa ranked second. The resistance of these bacteria tO antibiotics was on the increase. Besides, colonization of enterococcus and fungi on burn wound increased recently. This implied the importance of rational and correct use of antibiotics during early postburn ponrd.

关 键 词：烧伤创面 细菌 耐药性 抗生素 

分 类 号：R446.5[医药卫生—诊断学] R378[医药卫生—临床医学]