烧伤患者血培养菌谱调查及耐药性分析  

Pathogenic and drug-resistant bacteria isolated from blood culture of burn patients

作　　者：刘静[1] 刘红[2] 韩忠学[1] 巩静[1] 于兰[1] 刘媛媛[1] 

机构地区：[1]武警辽宁总队医院检验科,沈阳110034 [2]武警辽宁总队后勤部卫生处,沈阳110034

出　　处：《武警医学》2010年第10期856-858,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的分析我院烧伤患者血培养阳性标本病原菌分布情况及主要病原菌耐药性特点,为临床合理应用抗菌药物提供依据。方法采用细菌、真菌常规生化编码方法进行细菌、真菌鉴定,用K-B纸片法监测其耐药率。结果送检的968例血培养标本中,检出病原菌149株,阳性率为15.39%。其中,革兰阳性球菌83株,占55.70%,革兰阴性杆菌60株,占40.27%,真菌6株,占4.03%;分离出耐甲氧西林金黄色葡萄球菌(MRSA)57株,占93.44%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)11株,占84.62%。金黄色葡萄球菌对青霉素、红霉素、复方磺胺甲噁唑及头孢类都有很高的耐用性;凝固酶阴性葡萄球菌(CNS)对万古霉素、阿米卡星有较好的敏感性。分离出的8株肠球菌中HLAR占87.50%,有很高的耐药性。非发酵菌对头孢菌素、庆大霉素、阿米卡星、复方磺胺甲噁唑都有很高的耐药性。结论烧伤患者血培养病原菌主要有金黄色葡萄球菌、铜绿假单胞菌和凝固酶阴性葡萄球菌,且以耐药株为主。Objective To study the distribution of pathogenic and drug - resistant bacteria in blood culture of burn patients,and to offer clinical suggestions on proper use of antibiotics. Methods Bacteria were identified by routine biochemical study. Their resistance rates were screened by K - B method. Results In 968 blood cultures, 149 strains of pathogen were detected, including 83 strains of Gram - posi- tive cocci, 60 strains of Gram - negative bacilli and six strains of fungi. The positive rate of specimen was 15.39%. 57strains of methicillin -resistant staphylococcus aureus （MRSA）and 11 strains of methicillin -resistant coagulase -negative staphylococci（MRCNS） were detected. Staphylococcus aureus was antibiotic resistant to penicillin, erythromycin, sulfamethoxazole, and cephalosporins. Coagulase- negative staph- ylococci（CNS） were sensitive to vancomycin and amikacin. In eight strains of enterococcus, seven were high -level aminoglycoside resistant strains （HLAR）. Non-fermentative bacteria were resistant to cephalosporins, gentamicin, amikacin, and sulfamethoxazole. Conclusion Drug -resistant strains of staphylococcus aureus, pseudomonas aeruginosa and coagulase -negative staphylococci are the major pathogens in blood cultures of burn patients.

关 键 词：烧伤 血培养 耐药性 

分 类 号：R446.1[医药卫生—诊断学]