烧伤整形科患者感染病原菌分布及耐药性分析  

The pathogen distribution and antibiotic drug resistance analysis of patients hospitalized in burn and plastic department

作　　者：刘芳[1] 曹晋桂[1] 何晓峰[1] 吴镝[1] 焦立群[1] 张虎[1] 崔霞[1] 马文杰[1] 

机构地区：[1]空军总医院感染管理科,北京100142

出　　处：《实用口腔医学杂志》2013年第3期408-412,共5页Journal of Practical Stomatology

摘　　要：目的:了解2010～2011年烧伤整形科患者感染病原菌的分布以及耐药现状。方法:用VITEK2全自动微生物鉴定仪鉴定细菌及真菌;用纸片扩散Kirby-bauer(KB)法测定细菌对抗菌药物耐药性,并对其进行分析。结果:共分离出133株细菌,其中革兰阴性菌74株(55.6%),主要为大肠埃希菌、铜绿假单胞菌、奇异变形杆菌、鲍曼不动杆菌和阴沟肠杆菌;革兰阳性菌58株(43.6%),主要为金黄色葡萄球菌、粪肠球菌、表皮葡萄球菌、溶血葡萄球菌和人葡萄球菌;真菌1株(0.8%)为白色念珠菌。总体前5位的细菌依次为金黄色葡萄球菌33株(24.8%),大肠埃希菌16株(12.0%),铜绿假单胞菌10株(7.5%),奇异变形杆菌9株(6.8%)和鲍曼不动杆菌8株(6.0%)。其中2010年前5位的细菌依次为金黄色葡萄球菌、溶血葡萄球菌、阴沟肠杆菌、大肠埃希菌和肺炎克雷伯菌。2011年前5位的细菌与总体前5位的细菌排名相同。金黄色葡萄球菌中耐甲氧西林菌株23株,占到金黄色葡萄球菌71.9%。葡萄球菌属对多种抗菌药物的耐药率都在50%以上。肠杆菌科细菌对碳青霉烯类抗菌药物最为敏感。铜绿假单胞菌对喹诺酮类及碳青霉烯类抗菌药物比较敏感,对亚胺培南保持100%的敏感。鲍曼不动杆菌对头孢类抗菌药物的耐药率均达到100%,对碳青霉烯类抗菌药物的耐药率也在85%以上,对头孢哌酮/舒巴坦的耐药率最低,也达到62.5%。结论:烧伤整形科患者的致病菌耐药现象比较严重。Objective： To study the the pathogen distribution and drug resistance of the pathogens isolated from the patients hospital- ized in burn and plastic department of the hospital from 2010 to 2011. Methods： VITEK automatic microbial identification system was used to identify bacteria and fungi. The Kirby-bauer （KB） method was used to study the drug resistance of the pathogens isolated from patients hospitalized in burn and plastic department. Results： 133 pathogens, including 74 Gram-negative bacteria （55.6%）, main- ly Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Aciaetobacter baumannii and Enterobacter cloacae ; 58 gram-positive bacteria （43.6%）, mainly Staphylococcus aureus, Enterocaecus faecalis, Staphylococcus epidermidis, Staphylococcus haemolyticus and Staphylococcus hominis. 1 Fungus （0.8%） was Candida albicaus. The top 5 isolated bacteria of the overall ranking were Staphylococ- cus aureus 33 （24.8%）, Escherichia coli 16 （ 12. 0% ）, Pseudomonas aeruginosa 10 （7.5%）, Proteus mirabilis 9 （6.8%） and Acinetobacter baumannii 8 （6.0%）. In 2010 the top 5 bacteria isolated were Staphylococcus aureus, Staphylococcus haemolyticus, En- terobacter cloacae, Escherichia coli and KlebsieUa paeumoniae; in 2011 the top 5 were the same with the overall ranking. Methicillin- resistant Staphylococcus aureus were 23, accounted for 71.9% of Staphylococcus aureus. For Staphylococcus the resistance rates were above 50% of the most antimicrobial drugs. Enterobacteriaceae were more sensitive to carbapenems antimicrobial drugs. Pseudomonas aeruginosa were more sensitive to quinolone and carbapenem antimicrobial drugs and kept 100% sensitive to imipenem. For Acineto- bacter baumannii the resistance rate reached 100% to cephalosporin class of antimicrobial drugs, and more than 85% to carbapenems antimicrobial. To the cefoperazone/sulbactam,the resistance rate was 62.5%. Conclusion： The drug resistance of the pathogens i- solated from the patients hospitalized in burn and

关 键 词：烧伤整形科 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]