烧伤患者早期创面感染病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing early wound infections in burn patients

作　　者：王进勇[1] 邹飞扬[1] 李莉莉[1] 徐向荣[1] 张承德[1] 朱志英[1] 龚海南[1] 

机构地区：[1]常德市第一人民医院烧伤整形科,湖南常德415003

出　　处：《中华医院感染学杂志》2014年第18期4445-4447,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81203004)

摘　　要：目的分析烧伤患者早期创面感染病原菌分布及其耐药性,为烧伤创面感染的防治提供相关研究基础。方法选取医院2007年1月-2012年12月收治的2 981例烧伤患者中310例烧伤创面感染患者,对其早期创面病原菌进行检测,并分析主要致病菌的耐药性。结果 2 981例患者共出现355例创面感染,感染率11.9%,其中45例合并其他器官感染;共分离出病原菌329株,其中革兰阴性菌175株占53.2%,以铜绿假单胞菌和不动杆菌属为主,革兰阳性菌147株占44.7%,以金黄色葡萄球菌为主,真菌占2.1%;主要革兰阴性菌对亚胺培南耐药率较低,对氨苄西林、头孢曲松及头孢噻肟耐药率较高,金黄色葡萄球菌对青霉素、氨苄西林及克林霉素耐药率较高,对万古霉素耐药率较低。结论烧伤患者早期创面感染的发生率较高,且多数病原菌的耐药率呈逐年上升趋势,治疗中应严格按照抗菌药物使用指征行预防感染处理,并佐以相应支持治疗,避免病原菌产生交叉耐药性或变异,保证感染的预防和治疗效果。OBJECTIVE To analyze the distribution and drug resistance of pathogens causing early wound infections in the burn patients so as to provide guidance for prevention and treatment of burn wound infections .METHODS A total of 2 981 burn patients who were treated in the hospital from Jan 2007 to Dec 2012 were enrolled in the study , among whom 310 patients with burn wound infections were chosen as the study objects ,then the pathogens isola-ted from the early wounds were detected ,and the drug resistance of the major species of pathogens was analyzed . RESULTS Of the 2 981 patients ,the wound infections occurred in 355 cases with the infection rate of 11 .9% , among whom 45 cases were complicated with other sites of infections .Totally 329 strains of pathogens have been isolated ,including 175 （53 .2% ） strains of gram-negative bacteria , 147 （44 .7% ） strains of gram-positive bacteria ,and the fungi （2 .1% ）;the Pseudomonas aeruginosa and Acinetobacter were the predominant species of gram-negative bacteria ;the Staphylococcus aureus was dominant among the gram-positive bacteria .The main gram-negative bacteria showed low drug resistance to imipenem but were highly resistant to ampicillin ,ceftriax-one ,and cefotaxime;the drug resistance rates of the S .aureus to penicillin ,ampicillin ,and clindamycin were high ,and the drug resistance rate to vancomycin was low ;the drug resistance rates of the fungi to penicillin and clindamycin were high , and the drug resistance rates to vancomycin and imipenem-cilastatin were low . CONCLUSION The incidence of early wound infections is high among the burn patients ,and the drug resistance rates of most of the pathogens are increased year by year ;it is necessary to prevent the infections according to the indications for use of antibiotics and perform corresponding supportive therapy so as to avoid cross drug resistance or mutations of the pathogens and ensure the curative effect as well as prevention of infections .

关 键 词：烧伤 创面感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]