烧伤创面感染的病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing burn wound infections

作　　者：王毅[1] 郑德义[1] 程代微[1] 严晓寒[1] 

机构地区：[1]贵州省人民医院烧伤整形外科,贵州贵阳550002

出　　处：《中华医院感染学杂志》2015年第24期5663-5665,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81160234)

摘　　要：目的分析烧伤创面感染的病原菌分布及耐药性,为临床选取适宜的抗菌药物提供理论依据。方法随机选取医院2012年6月-2014年6月150例烧伤感染患者作为研究对象,从其送检创面分泌物标本使用法国生物梅里埃公司Bact/Alert3D血培养仪进行细菌培养,并行药敏试验,数据采用SPSS 19.0软件进行统计分析。结果烧伤感染患者分离出217株病原菌,以革兰阴性菌为主,共141株占65.0%,其中以鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌居首,分别占17.5%、17.1%、13.4%;革兰阴性菌对亚胺培南、美罗培南的耐药率低,对一代头孢菌素的耐药率较高,鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌对亚胺培南的耐药率分别为78.9%、24.3%、0。结论导致烧伤患者感染的病原菌以革兰阴性菌为主,且现在主要病原菌的耐药性已发生变化,临床应监测病原菌及其耐药性,依据药敏试验结果,选取适宜的抗菌药物,以增加疗效,减少多药耐药菌的产生。OBJECTIVE To analyze the distribution and drug resistance of pathogens causing burn wound infections so as to provide a theoretical basis for clinical selection of appropriate antimicrobial agents. METHODS Totally 150 cases of burn infections in the hospital from Jun.. 2012 to Jun. 2014 were randomly selected as the research subjects. Secretion samples were isolated from wounds and the pathogens were cultured using the French BioMerieux Bact Alert3D blood culture system and the drug Sensitive test was conducted. The software SPSS 19.0 was used for statistical analysis of data. RESULTS Among the 217 isolated pathogens, gram-negative bacteria were prevalent with a total amount of 141 strains, accounting for 65.0%. Among them, Acinetobacter Baumannii, Pseudornonas aeruginosa, and Escherichia coli were themost common, accounting for 17.5%, 17.1%, and 13.4%;. respectively. The gram-negative bacteria had low resistance to imipenem and meropenem and high resistance to the first generation eephalosporin. The resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa, and Escherichia coli to imipenem were 78.9%, 24.3%, and 0.0%, respectively. CONCLUSION Burn infections are mostly caused by gram-negative bacteria, and now the drug resistance of main pathogens has changed. Clinical staff shquld detect pathogens and their drug resistance, and select the appropriate antimicrobial drugs according to the susceptibility test results to increase efficacy and reduce the generation of multi-drug resistant bacteria.

关 键 词：烧伤 创面感染 病原菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]