烧伤整形外科1963株细菌及其耐药情况分析  

Analysis on 1963 strains of bacteria and the drug resistance in Department of Burn Plastic Surgery

作　　者：丁华荣[1] 胡加平 李德绘[1] 莫贵 Ding Huarong;Hu Jiaping;Li Dehui;Mo Gui(Department of Burn Plastic Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院烧伤整形外科,南宁530021

出　　处：《广西医科大学学报》2019年第1期102-106,共5页Journal of Guangxi Medical University

摘　　要：目的:分析烧伤整形外科细菌感染及其耐药情况,为临床合理使用抗生素提供依据。方法:收集2013年1月至2017年12月广西医科大学第一附属医院烧伤整形外科烧伤住院患者1 643例,共收集4 785份标本,采用WHONET5.6软件统计分析标本中病原菌分布及抗生素耐药情况。结果:4 785份送检标本中,培养出1 855株细菌,阳性率38.76%,其中创面分泌物标本细菌分离率占72.72%。在分离菌中,G-菌主要为鲍曼不动杆菌、铜绿假单胞菌等,占77.84%;G+菌为金黄色葡萄球菌、肠球菌和溶血性葡萄球菌,占22.16%。鲍曼不动杆菌对替加环素和米诺环素较敏感,对头孢唑林、氨苄西林等几乎全部耐药;铜绿假单胞菌对多黏菌素B耐药率低,对阿米卡星、左氧氟沙星、美罗培南和哌拉西林/他唑巴坦耐药率为26%～31%,对氨苄西林、头孢曲松等几乎全部耐药;大肠埃希菌对碳青霉烯类抗生素、哌拉西林/他唑巴坦和阿米卡星耐药率低,对氨苄西林、头孢唑林等的耐药率高达79%;肺炎克雷伯菌对碳青霉烯类抗生素、阿米卡星、哌拉西林/他唑巴坦耐药率低,对氨苄西林全部耐药;阴沟肠杆菌对碳青霉烯类、阿米卡星、哌拉西林/他唑巴坦和左氧氟沙星耐药率低,对头孢唑林、头孢呋辛和头孢西丁几乎全部耐药。金黄色葡萄球菌、肠球菌和溶血性葡萄球菌对替考拉宁、利奈唑胺、替加环素耐药率低,对红霉素、苯唑西林和四环素耐药率均非常高。结论:烧伤整形外科病原菌以G-杆菌为主,细菌耐药率高,尤其是鲍曼不动杆菌和铜绿假单胞菌耐药,且出现对碳青霉烯类抗生素耐药现象,应该引起重视。Objective:To analyzed the condition of bacterial infection and drug resistance in Department of Burn Plastic Surgery,and to guide the proper use of antibiotics.Methods:From January 2013 to December 2017,4,785 bacteriological specimens were collected from the burn and plastic surgery ward of our hospital.The pathogenic bacteria distribution and antibiotic resistance of 1,963 positive specimens were analyzed by WHONET5.6 software.Results:Of the 4,785 specimens,1,855 bacteria were cultured,and the positive rate of bacteria culture was 38.76%,which wound secretion specimens bacteria separation rate accounts for 72.72%of total specimens bacteria separation rate.In isolated bacteria,Gram-negative bacteria mainly included Acinetobacter baumannii,Pseudomonas aeruginosa,etc.(77.84%).Gram-positive bacteria mainly included Staphylococcus aureus,Enterococcus and Staphylococcus hemolyticus(22.16%).The relatively sensitive antibiotics for Acinetobacter baumannii were tigacycline and minocycline,and almost all of them were resisted to cefazolin,ampicillin,etc.The most sensitive antibiotics of Pseudomonas aeruginosa was colistin B.The resistance rates to amikacin,levofloxacin,meropenem and piperacillin/tazobactam ranged from 26%to 31%,and almost all of them were resistant to ampicillin,ceftriaxone,etc.The more sensitive antibiotics of Escherichia coli were penicillium carbon alkene antibiotics,piperacillin/tazobactin and amikacin.The drug resistance rate to ampicillin,cefazolin,etc.was up to 79%.The more sensitive antibiotics of Klebsiella pneumoniae were penicillium carbon alkene antibiotics,amikacin,piperacillin/tazobactin,but all of them were resistant to ampicillin.The more sensitive antibiotics of Enterobacter cloacae were penicillium carbon alkene antibiotics,amikacin,piperacillin/tazobactin and levofloxacin,and almost all of them were resistant to cefazolin,cefuroxime and ceficidin.The antibiotics sensitive to Staphylococcus aureus,Enterococcus and Staphylococcus haemolyticus were tigacycline,linazolamide and tigecycline,

关 键 词：烧伤整形外科病房 细菌感染 抗菌药物 耐药率 

分 类 号：R644[医药卫生—外科学]