烧伤病房不同病种患者创面病原菌分布及耐药性对比研究  

Distribution and drug resistance of pathogenic bacterial isolated from different kinds of wounds in burn wards

作　　者：倪俊[1] 顾海峰[1] 许献荣[1] 陈瑞彩[1] 张杏梅[1] 

机构地区：[1]解放军第85医院烧伤整形外科,上海200052

出　　处：《中华医院感染学杂志》2013年第19期4832-4834,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析烧伤病房不同病种患者创面病原菌分布及耐药性,为临床合理选用抗菌药物提供依据。方法对2006年1月-2012年6月烧伤病房收治患者288份创面标本进行分析,采用K-B纸片扩散法对分离出的病原菌进行药物敏感试验,并对其耐药性进行研究。结果共分离出病原菌205株,检出率71.18%,包括革兰阳性菌91株占44.39%,革兰阴性菌113株占55.12%,真菌1株占0.49%;常见病原菌中金黄色葡萄球菌在烧伤难愈性创面多见,铜绿假单胞菌、鲍氏不动杆菌在非烧伤难愈性创面多见;革兰阳性菌对青霉素、红霉素、苯唑西林和克林霉素的耐药率>70.00%,革兰阴性菌对头孢唑林、头孢噻肟、阿莫西林/克拉维酸的耐药率>60.00%,3类创面的病原菌耐药率也有差异。结论不同病种创面的细菌分布和耐药性有差异,临床工作中需根据不同的创面采取不同的抗感染治疗措施。OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria isolated from different kinds of wound in burn wards and provide the basis for clinical rational use of antimicrobial agents. METHODS Pathogenic bacteria were isolated from different kinds of wound in burn wards from Jan 2006 to Jun 2012. K-B slip diffusion method was taken to carry out the drug susceptibility testing. Rate of drug resistance of pathogenic bacteria was analyzed. RESULTS Totally 205 strains were isolated, with the detection rate of 71.18%, among which 91 strains were gram-positive bacteria, accounting for 44. 39%, 113 strains were gram-negative bacteria, accounting for 55.12% and 1 strain was fungus, accounting for 0.49%. In the common bacteria, Staphylococcus aureus were more common in burn refractory wound, while Pseudornonasaeruginosa and Acinetobacterbaumannii were more common in non-burn refractory wound. Thedrug resistance rates of the gram-positive bacteria to penicillin, erythromycin, oxacillin, and clindamycin were more than 70.00%, while the drug resistance rates of the gram-negative bacteria to cefazolin, cefotaxime, amoxicillin, and clavulanic acid were more than 60.00 %. The pathogens isolated from the three types of wound secretion differed in the drug resistance rate. CONCLUSION There are different distribution and drug resistance of pathogenic bacterial isolated from different kinds of wounds. We need to take different antimicrobial therapy measures for different kinds of wound in clinical treatment.

关 键 词：烧伤 创面 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]