宁夏地区成批烧伤患者感染病原菌的特点及耐药性分析  

Prevalence and drug resistance of pathogens in patients with mass burn

作　　者：金少华[1] 李传吉[1] 张龙[1] 邓兴旺[1] 齐旭辉 张丽香[1] 黄涛[2] 梁根秀 

机构地区：[1]宁夏石嘴山市第一人民医院烧伤科,宁夏石嘴山753000 [2]宁夏石嘴山市第一人民医院中心实验室,宁夏石嘴山753000

出　　处：《宁夏医学杂志》2015年第6期527-531,共5页Ningxia Medical Journal

基　　金：宁夏卫生厅科研资助项目(2009083)

摘　　要：目的回顾分析成批烧伤患者和非成批烧伤患者院内感染病原菌分布及耐药性状况的流行病学变化。方法选择收治的成批烧伤患者316例与同时期非成批生活烧伤患者361例,分析2组患者各年度创面分泌物、血液、痰液、气管套管,及深静脉置管标本中的病原菌的菌种、分布特点、耐药性变化。结果成批烧伤患者发现病原菌感染282例(89.24%),非成批烧伤患者发现病原菌感染197例(54.57%),前者感染发生率明显高于后者。其中,成批烧伤组检出病原菌351株(54.84%),革兰氏阳性(G+)球菌213株(60.68%)。非成批烧伤组检出病原菌289株(45.16%),革兰氏阳性(G+)球菌161株(55.71%)。成批烧伤组患者检出甲氧西林耐药金黄色葡萄球菌(MRSA)59株(64.84%),甲氧西林耐药表皮葡萄球菌(MRSE)31株(64.58%);非成批烧伤组患者MRSA 61株(60.40%),MRSE16株(61.54%)。金黄色葡萄球菌、表皮葡萄球菌、大肠埃希菌和铜绿假单胞菌等对常见抗生素的耐药性增加,并呈多重耐药性。结论成批烧伤患者病原菌感染发生率较非成批烧伤患者明显增加,金黄色葡萄球菌、表皮葡萄球菌、大肠埃希菌和铜绿假单胞菌等常见致病菌对常见抗生素的耐药性增加,并呈多重耐药性。Objective To retrospectively study the prevalence and drug resistance of pathogens in patients with mass burn and patients with non - mass in our department and to evaluate the trend of time related changes in recent years. Methods Retrospective a- nalysis of microbiological results from 316 patients with mass burn and 361 patients with non - mass burn hospitalized in our department was carried out, including microbiological results of wound secretion, blood sample, sputum specimen, tracheal tube and central venous catheter specimen. Results 282 patients （89.24%） were detected with pathogen in mass burn patients, with higher prevalence rate than non - mass burn patients （ 197,54.57% ）. 351 strains of pathogens were detected in mass burn patients （54.84%）, including 213 strains of Gram - positive cocci （60.68%）, 129 strains of Gram - negative bacilli （ 36.75% ） and 9 strains of fungi （ 2.56% ）, while 161 strains of Gram - positive cocci （55.71%）, 120 strains of Gram - negative bacilli （41.52%） and 8 strains of fungi （2.77%） ,to- tally 289 strains of pathogens were detected in patients with non - mass burn （45.16%）. The most common Gram - positive cocci were staphylococcus anreus, staphylococcus epidermidis and staphylococcus capitis in both mass burn patients and non - mass burn patients. The most common Gram - negative bacilli were escherichia coli, pseudomonas aeruginosa and Serratia marcescens in mass burn patients, whereas pseudomonas aeruginosa, escheriehia coli and baumanii in non - mass burn patients. 59 strains （64. 84% ） and 61 strains （60.40%） of MRSA （methicillin - resistant staphylococcus aureus） and 31 strains （64.58%） and 16 strains （61.54%） of MRSE （ methicillin - resistant staphylococcus epidermis） were detected in mass/non - mass burn patients respectively. The drug resistance of staphylococcus aureus, staphylococcus epidermidis, escherichia coli and pseudomonas aeruginosa to common antibiotics was time related increased, emerging as

关 键 词：烧伤 病原菌 院内感染 耐药性 

分 类 号：R644[医药卫生—外科学]