2015-2016年烧伤科住院患者感染细菌分布及耐药性分析  

PATHOGENIC BACTERIA AND ANTIMICROBIAL SUSCEPTIBILITY OF INFECTED BURN PATIENTS IN THE BURN DEPARTMENT FROM 2015 TO 2016

作　　者：付妍婕[1] 于凤娜[1] 刘荣朋 吴鹏[1] 王仁恒 彭京梁 孙淑红[2] FU Yan-jie;YU Feng-na;LIU Rong-peng(Department of Burn and Plastic Surgery,Linyi People’s Hospital,Linyi 276003,China;Laboratory Center,Linyi People’s Hospital,Linyi 276003,China)

机构地区：[1]临沂市人民医院烧伤整形科,山东临沂276003 [2]临沂市人民医院检验科,山东临沂276003

出　　处：《山东医学高等专科学校学报》2018年第1期5-9,共5页Journal of Shandong Medical College

基　　金：临沂市科技发展计划项目(2016166012)

摘　　要：目的了解近2年医院烧伤科住院患者感染细菌分布特征与耐药状况,指导临床用药。方法收集2015年1月至2016年12月烧伤科住院患者的创面分泌物、痰液、尿、血液等标本进行细菌培养及药敏分析。结果 1842例患者共行细菌培养患者368例,有187例发生感染,共培养病原菌209株,以革兰阴性杆菌为主(73%),其次为革兰阳性球菌(25%),真菌2%。鲍曼不动杆菌对美罗培南、亚胺培南、头孢他定、头孢比肟、哌拉西林他唑巴坦耐药率92%以上,对多粘菌素B、阿米卡星和替甲环素的耐药率较低。大肠埃希菌对左氧氟沙星的耐药率达到75%,但对替加环素100%敏感,对碳青霉烯类、阿米卡星90%以上敏感。肺炎克雷伯菌仅对头孢曲松钠耐药率达到40%。铜绿假单胞菌对呋喃妥因耐药率100%,其他药物耐药率在30%以内。球菌对头孢西丁、克林霉素耐药率达到70%以上,对万古霉素、利奈唑胺、替加环素尚无耐药。结论烧伤科病原菌对临床使用抗菌药物的耐药性较高,必须予以高度重视,了解烧伤科感染细菌分布及其耐药性,可根据本病房的致病菌种及耐药情况合理选择抗菌药物,提高临床治疗效果。Objective To investigate the distribution and drug resistance of bacteria isolated from burn patients in hospital during the past 2 years,so as to guide the clinical use of drugs.Methods Samples of wound secretion,sputum,urine and blood were collected from burn patients from January 2015 to December 2016.Bacterial culture and drug sensitivity analysis were performed.Results 368 Of the 1842 patients were infected by bacteria,and 187 cases were infected.209 strains of pathogenic bacteria were cultured,mainly gram-negative bacilli(73%),followed by Gram positive cocci(25%),fungi 2%.The resistance rate of Bauman acinetobacter to meropenem,imipenem,ceftazidime,cefepime,piperacillin tazobactam is more than 92%,but resistance rates of what to polymyxin B,Amikacin and tigecycline was lower.The resistance rate of Escherichia coli to levofloxacin was 75%,but it was sensitive to Tigecycline for 100%,sensitive to carbapenems and Amikacin was more than 90%.The resistance rate of Klebsiella pneumoniae to ceftriaxone sodium was only 40%.The resistance rate of Pseudomonas aeruginosa to furazolidone was 100%,and the resistance rate of other drugs was less than 30%.Aureus on to cefoxitin and clindamycin resistance rate reached more than 70%,vancomycin,linezolid,tigecycline,no drug resistance.Conclusion The resistance of pathogenic bacteria in burn department to clinical use of antibiotics is high,so we must take great care to it.According to the pathogenic bacteria and drug resistance in the ward,rational selection of antibacterial drugs,improve the clinical treatment effect.

关 键 词：烧伤 细菌 抗菌药物 耐药率 

分 类 号：R378[医药卫生—病原生物学]