烧伤外科与非烧伤外科住院患者感染细菌特点及耐药性的对比研究  

A comparative study of the characteristic and antibiotic resistance of clinical isolates in burn unit and non-burn surgery unit of inpatients

作　　者：鞠晓红[1] 宿丽娟[2] 马爱新[1] 

机构地区：[1]吉林医药学院病原教研室,吉林132013 [2]吉林市吉化集团总医院检验科,吉林132022

出　　处：《中国抗生素杂志》2010年第9期695-699,共5页Chinese Journal of Antibiotics

摘　　要：目的了解烧伤外科与非烧伤外科住院患者感染病原菌及耐药性差异,为临床抗感染治疗提供依据。方法常规培养鉴定细菌,K-B法进行药敏试验,分析其临床分布及耐药性。结果烧伤外科共分离出325株细菌,以金黄色葡萄球菌、铜绿假单胞菌和粪肠球菌为主要病原菌,标本主要分布于创面分泌物和血液;非烧伤外科分离出289株细菌,排前3位的依次是大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌,标本主要分布于痰和伤口分泌物。烧伤外科和非烧伤外科分别有68.57%和63.41%的大肠埃希菌为ESBLs株,66.10%和38.24%的金黄色葡萄球菌为MRSA。亚胺培南和美罗培南对肠杆菌科细菌和不动杆菌属的耐药率为0～7.14%,烧伤科铜绿假单胞菌对两药的耐药率分别是56.52%和43.48%,非烧伤外科则分别是5.88%和11.76%。烧伤科大肠埃希菌较敏感的药物还有阿米卡星、头孢西丁。所有革兰阳性球菌耐药性严重,未发现万古霉素耐药株。结论烧伤外科与非烧伤外科住院患者感染病原菌种类及耐药性存在明显差异,临床应合理应用抗菌药物,避免耐药菌产生及流行。Objective To investigate the bacterial flora and drug resistance in burn inpatients and non-burn surgery wards for rational antimicrobial therapy. Methods Bacteria were isolated and identitied by conventional culture, and drug resistance test was performed by K-B method. Results There were mainly S. aureus, P. aeruginosa and E. faecalis among 325 strains from burn patients specimens. The specimens were mainly from burn wound and blood. Totally 289 strains were isolated from non-burn surgery inpatients and ranking the top 3 groups were E. coli, K. pneumoniae and S. aureus. Infection sites occurred mainly in lower respiratory tracts, followed by wound. The detection rates of ESBLs producing E. coli in burn inpatients and non-burn surgery wards were respectively 68.57% and 63.41%, and the isolating rate of MRSA were respectively accounted for 66.10% and 38.24%. Enterobacteriaeeae and Aeinetobacter were most susceptible to imipenem and meropenem, and the resistant rates were from 0 to 7.14%. P aeruginosa were respectively 56.52% and 43.48% in burn unit, and non-burn surgery wards were 5.88% and 11.76%, respectively. E. coli in burn units was susceptible to amikacin and cefoxitin. The resistance status of gram-positive coccus is very serious, but no strain resistant to vancomycin was found. Conclusion There are obviously difference of strain and drug resisitance in burn patients and other surgery patients. Clinicians should reasonably choose antibiotics to avoid occurrence and prevalence of drug resistance bacterium.

关 键 词：外科 烧伤 住院患者 感染率 耐药性 

分 类 号：R378[医药卫生—病原生物学]