烧伤患者创面感染病原菌分布及药敏分析  

Distribution and drug susceptibility of pathogens causing wound infections in burn patients

作　　者：陈粹[1] 范友芬[1] 邬薇薇[1] 许小敏[2] 杨冬[3] 

机构地区：[1]宁波市第二医院烧伤科,浙江宁波315010 [2]宁波市第二医院检验科,浙江宁波315010 [3]浙江省医学科学院,浙江杭州310013

出　　处：《中华医院感染学杂志》2014年第4期841-843,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生研究基金项目(2011KYA001)

摘　　要：目的分析烧伤患者创面感染病原菌分布及药物敏感性,以更好地指导烧伤患者安全的使用抗菌药物。方法选取2012年10月-2013年3月医院收治的100例烧伤患者为研究对象,使用无菌棉拭子采集患者创面分泌物或者手术中取痂下坏死组织,采用GPI生化鉴定卡以及全自动微生物分析仪鉴定病原菌,体外的药物敏感试验采用K-B法进行,结果判断按照美国临床实验室标准化研究所制定的标准。结果 100例患者中共检出病原菌520株,其中金黄色葡萄球菌300株、铜绿假单胞菌200株、鲍氏不动杆菌及表皮葡萄球菌各10株,分别占57.7%、38.5%、1.9%、1.9%;铜绿假单胞菌对亚胺培南、磺胺嘧啶银、磺胺甲噁唑/甲氧苄啶、头孢他啶敏感率分别为78.5%、96.0%、83.0%、78.5%,鲍氏不动杆菌对磺胺甲噁唑/甲氧苄啶、亚胺培南、阿米卡星的敏感率分别为70.0%、60.0%、50.0%;金黄色葡萄球菌对万古霉素、磺胺甲噁唑/甲氧苄啶、磺胺嘧啶银的敏感率分别为95.7%、85.0%、71.3%,表皮葡萄球菌则对万古霉素和头孢他啶的敏感率分别为90.0%、80.0%。结论烧伤患者存在多种感染,病原菌对常用抗菌药物的敏感性较低,因此,应当加强烧伤患者的病原菌耐药检测,指导烧伤患者安全使用抗菌药物,使患者早日恢复健康。OBJECTIVE To analyze the distribution and drug susceptibility of pathogens causing wound infections in burn patients so as to guide reasonable use of antibiotics. METHODS A total of 100 burn patients, who were treated in the hospital from Oct 2012 to Mar 2013, were enrolled in the study, then the wound secretions were collected by using aseptic cotton swab, or the necrotic tissues under the scab were sampled, the pathogens were identified with the use of GPI biochemical identification card and automatic microorganism analyzer, the in vitro drug susceptibility testing was performed by means of K-B method, and the results were determined by referring to the standards specified by Clinical Laboratory Standards Institute. RESULTS Totally 520 strains of pathogens have been isolated from the 100 patients, among which there were 300 （57.7o/oo） strains of Staphylococcus au- reus, 200 （38.5%） strains of Pseudomonas aeruginosa, 10 （1.9%） strains of Acinetobacter baumannii, and 10 （1.9%） strains of Staphylococcus epidermidis. The drug susceptibility rates of the P. aeruginosa to imipenem, silver sulfadiazine, sulfamethoxazole/trimethoprim, and ceftazidime were 78.5 %, 96.0%, 83.0%, and 78.5 %, respectively; the drug susceptibility rates of the A. baumannii to sulfamethoxazole/trimethoprim, imipenem, and amikacin were 70. 0%, 60. 0%, and 50. 0%, respectively; the drug susceptibility rates of the S. aureus to vancomycin, sulfamethoxazole/trimethoprim, and silver sulfadiazine were 95. 7%, 85. 0%, and 71. 3%, respectively; the drug susceptibility rates of the S. epiderrnidis to vancomyein and ceftazidime were 90. 0% and 80.0 %, respectively. CONCLUSIONS There are a variety of infections in the burn patients; the drug susceptibility rates of the pathogens to the commonly used antibiotics are low, therefore, it is necessary to strengthen the test of drug resistance and guide the reasonable use of antibiotics so as to promote the early recovery of patients

关 键 词：烧伤 抗菌药物 病原菌 敏感性 

分 类 号：R378[医药卫生—病原生物学]