烧伤病房患者病原菌调查及耐药性监测  

Distribution and drug resistance of pathogens isolated from burn wound patients

作　　者：李婧[1] 王会中[2] 张金树[2] 

机构地区：[1]北京军区总医院检验科,北京100026 [2]解放军305医院检验科,北京100017

出　　处：《中华医院感染学杂志》2014年第17期4211-4213,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81270059)

摘　　要：目的分析烧伤病房患者病原菌分布及耐药性,为临床合理选用抗菌药物提供依据。方法收集医院烧伤科2009年1月-2012年10月烧伤患者的创面分泌物中分离的病原菌,采用纸片扩散法(K-B法)进行药敏试验。结果共分离出病原菌358株,其中革兰阴性菌212株,占59.22%,以铜绿假单胞菌、阴沟肠杆菌、大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌为主,革兰阳性球菌126株,占35.19%,以金黄色葡萄球菌为主,真菌20株,占5.59%,以白色假丝酵母菌为主;主要革兰阴性菌对亚胺培南、美罗培南较敏感,但鲍氏不动杆菌对亚胺培南、美罗培南耐药率较高,革兰阳性菌对万古霉素、替考拉宁较敏感。结论烧伤病房患者感染的病原菌以革兰阴性菌为主,主要病原菌产生多药耐药性,因此,应加强烧伤病房病原菌分布及其耐药性监测,指导临床合理用药,减少耐药株的产生。OBJECTIVE To explore the distribution and drug resistance of pathogens isolated trom the pattents of burn wound wards so as to provide guidance for reasonable clinical use of antibiotics. METHODS The pathogens were isolated from wound secretions that were obtained from the burn wound patients who were treated in the burn wound department from Jan 2009 to Oct 2012, then the drug susceptibility testing was performed by using disk diffusion method （K-B method）. RESULTS A total of 358 strains of pathogens have been isolated, including 212 （59.22%） strains of gram-negative bacteria, 126 （35. 19%） strains of gram-positive cocci, and 20 （5. 59%） strains of fungi; the Pseudomonas aeruginosa , Enterobacter cloacae, Escherichia coli , Acinetobacter baurnannii , and Klebsiella pneumoniae were the predominant species of gram-negative bacteria; the Staphylococcus aureus was dominant among the gram-positive bacteria; the Candida albicans was the predominant species of fungi. The main gram-negative bacteria were highly susceptible to imipenem and meropenem, however, the drug resistance rates of the A. baumannii to imipenem and meropenem were high; the gram-positive bacteria were highly susceptible to vancomycin and teicoplanin. CONCLUSION The gram-negative bacteria are the predominant pathogens causing infections in the burn wound patients, and the main pathogens are multidrug-resistant, therefore, it is necessary to strengthen the surveillance of distribution and drug resistance of the pathogens and reasonably use antibiotics so as to reduce the drug-resistant strains.

关 键 词：烧伤患者 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]