烧烫伤患者多重耐药菌感染情况及药敏分析  

Analysis of multi-drug resistant bacteria infection and drug susceptibility in scald burn patients

作　　者：王少明 亓广伟 WANG Shao-ming;QI Guang-wei(Department of Clinical Laboratory,960 Hospital of PLA Joint Logistic Support Force,Jinan 250000,China)

机构地区：[1]解放军联勤保障部队第九六〇医院检验科,250000 [2]解放军联勤保障部队第九六〇医院肛肠外科,250000

出　　处：《中国实用医药》2023年第20期81-84,共4页China Practical Medicine

摘　　要：目的探讨烧烫伤患者多重耐药菌感染情况及药敏情况。方法120例烧烫伤患者作为研究对象,对其创面分泌物、血液、痰液、中段尿以及静脉置管等系列标本送检,合理展开细菌培养操作、分离操作以及鉴定操作。采用最低抑菌浓度(MIC)方法以及K-B纸片琼脂扩散法完成药敏试验操作,分析菌株来源分布情况、病原菌分布情况、多重耐药菌耐药性。结果共分离出213株多重耐药菌。其中来源于创面分泌物148株,占比69.48%;来源于血液标本32株,占比15.02%;来源于痰液标本13株,占比6.10%;来源于中段尿标本6株,占比2.82%;来源于静脉置管标本5株,占比2.35%;来源于其他标本9株,占比4.23%。213株多重耐药菌中,65株金黄色葡萄球菌,占比30.52%;53株铜绿假单胞菌,占比24.88%;42株大肠埃希菌,占比19.72%;12株肺炎克雷伯菌,占比5.63%;9株鲍曼不动杆菌,占比4.23%;8株奇异变形杆菌,占比3.76%;5株阴沟杆菌,占比2.35%;2株肠球菌,占比0.94%;17株其他肠杆菌,占比7.98%。金黄色葡萄球菌对万古霉素以及替考拉宁耐药率最低,为0;对红霉素的耐药率最高,为76.92%。铜绿假单胞菌对替加环素耐药率最低,为0;对庆大霉素的耐药率最高,为56.60%。大肠埃希菌对替加环素耐药率最低,为0;对庆大霉素的耐药率最高,为69.05%。结论烧烫伤患者的多重耐药菌多来源于创面分泌物标本,以铜绿假单胞菌、金黄色葡萄球菌以及大肠埃希菌为主要病原菌。采用替考拉宁以及万古霉素对多重耐药菌进行治疗,可以获得较好效果。而对于替加环素而言,其针对多重耐药革兰阴性菌表现出较好敏感性,但因为有较明显的不良反应,不宜作为一线药物对患者实施治疗。Objective To discuss the multi-drug resistant bacteria infection and drug susceptibility in scald burn patients.Methods 120 cases of scald burn patients were studied,and a series of specimens including secretion,blood,sputum,midstream urine and intravenous catheterization were sent for examination,and bacterial culture,separation and identification operations were carried out in a reasonable manner.The minimum inhibitory concentration(MIC)method and K-B paper agar diffusion method were used to complete the drug susceptibility test.The distribution of bacterial strains,the distribution of pathogenic bacteria,and the resistance of multidrug resistant bacteria were analyzed.Results A total of 213 strains of multi-drug resistant bacteria were isolated.Among them,148 strains from wound secretion,accounting for 69.48%;32 strains from blood specimen,accounting for 15.02%;13 strains from sputum specimen,accounting for 6.10%;6 strains from midstream urine specimen,accounting for 2.82%;5 strains from intravenous catheterization specimen,accounting for 2.35%;9 strains from other specimens,accounting for 4.23%.Among 213 strains of multi-drug resistant bacteria,65 strains of Staphylococcus aureus,accounting for 30.52%;53 strains of Pseudomonas aeruginosa,accounting for 24.88%;42 strains of Escherichia coli,accounting for 19.72%;12 strains of Klebsiella pneumoniae,accounting for 5.63%;9 strains of Acinetobacter baumannii,accounting for 4.23%;8 strains of Proteus mirabilis,accounting for 3.76%;5 strains of enterobacter cloacae,accounting for 2.35%;2 strains of enterococcus,accounting for 0.94%;17 strains of other enterobacter,accounting for 7.98%.Staphylococcus aureus had the lowest resistance to vancomycin and teicoplanin at 0,and the highest resistance to erythromycin at 76.92%.Pseudomonas aeruginosa had the lowest rate of resistance to teicoplanin at 0;and the highest rate of resistance to gentamicin at 56.60%.Escherichia coli had the lowest rate of resistance to teicoplanin at 0;and the highest rate of resistance to gentami

关 键 词：多重耐药菌感染 烧烫伤 药敏分析 

分 类 号：R644[医药卫生—外科学] R446.5[医药卫生—临床医学]