危重烧伤患者感染创面病原菌分布耐药性调查研究  

Investigation and Study on the Distribution and Drug Resistance of pathogenic Bacteria in infectious Wounds of critical Burn Patients

作　　者：王菲[1] 李肇蕤 崔岭峰 薛飒 孙彦威 WANG Fei;LI Zhaorui;CUI Lingfeng;XUE Sa;SUN Yanwei(Department of Medical Laboratory,Nanyang Central Hospital,Nanyang Henan 473000,China)

机构地区：[1]南阳市中心医院医学检验科,河南南阳473000

出　　处：《临床研究》2024年第3期4-7,共4页Clinical Research

摘　　要：目的分析与研究危重烧伤患者创面感染病原菌分布及耐药性。方法选取南阳市中心医院2020年1月至2023年1月96例危重烧伤患者作为研究对象,收集患者创面、静脉血、脓液、痰液等分泌物,另对病原菌感染情况及耐药变化分析。结果96例危重烧伤患者,其中76例感染病原菌,感染率是79.17%,检出病原菌株215株,主要来源于创面分泌物,占37.67%,其次是静脉血、脓液、痰液、其他、尿液,分别占26.98%、12.56%、8.84%、7.44%、6.51%,并且呈逐年递增趋势,检出率由23.26%上升到45.12%;革兰氏阳性菌111株,金黄色葡萄球菌株占16.28%,其中,耐甲氧西林金黄色葡萄球菌(MRSA)占金黄色葡萄球菌40.00%;共91株革兰氏阴性菌,铜绿假单胞菌检出率占14.42%,其次是大肠埃希菌,检出率是8.84%,真菌共13株,占6.05%;MRSA对利奈唑胺、替考拉宁、万古霉素敏感,并未出现耐药菌株,而对氟喹诺酮类、利福平、庆大霉素抗菌药物耐药率均<20%,对红霉素、克林霉素耐药率达85.71%;在革兰氏阴性菌中,铜绿假单胞菌检出率为最高,对头孢唑林、头孢呋辛、头孢呋辛酯、头孢替坦耐药率高,而对氨基糖苷类、喹诺酮类耐药率低;在大肠埃希菌中,对环丙沙星、左氧氟沙星耐药率高,并呈逐年升高趋势,对头孢呋辛、头孢呋辛酯无耐性。结论危重烧伤患者病原菌以金黄色葡萄球菌、铜绿假单胞菌、大肠埃希菌为主,出现多重用药,因此,通过定期监测病原菌分布、耐药性迁移能有效控制耐药菌发展。Objective To analyze and study the distribution and drug resistance of pathogens causing wound infection in critically burn patients.Methods A total of 96 critically burned patients from Nanyang Central Hospital from January 2020 to January 2023 were selected as the research subjects.Secretions such as wounds,venous blood,pus,and sputum were collected from the patients,and the infection status and drug resistance changes of pathogens were analyzed.Results Among the 96 critically burned patients,76 were infected with pathogens,with an infection rate of 79.17%.A total of 215 strains of pathogenic bacteria were detected,mainly from wound secretions,accounting for 37.67%,followed by venous blood,pus,sputum,other fluids,and urine,accounting for 26.98%,12.56%,8.84%,7.44%,and 6.51%,respectively,and showing an increasing trend year by year,the detection rate increased from 23.26%to 45.12%;101 strains of gram-positive bacteria,of which 16.28%are staphylococcus aureus,of which MRSA accounts for 40.00%;There are a total of 91 gram-negative bacteria,with a detection rate of 14.42%for pseudomonas aeruginosa,followed by escherichia coli with a detection rate of 8.84%,and a total of 13 fungi with a detection rate of 6.05%;MRSA is sensitive to linezolid,teicoplanin,and vancomycin,and no resistant strains have emerged.However,the resistance rate to fluoroquinolones,rifampicin,and gentamicin antibiotics is less than 20%,and the resistance rate to erythromycin and clindamycin is 85.71%;Among gram negative bacteria,pseudomonas aeruginosa has the highest detection rate,with high resistance to cefazolin,cefuroxime,cefuroxime axetil,and cefotetan,while low resistance to aminoglycosides and quinolones;In escherichia coli,the resistance rate to ciprofloxacin and levofloxacin is high and is increasing year by year,with no tolerance to cefuroxime and cefuroxime axetil.Conclusion The pathogenic bacteria in critically burned patients are mainly staphylococcus aureus,pseudomonas aeruginosa,and escherichia coli,with multiple drug uses.Therefor

关 键 词：感染创面 烧伤 病原菌 耐药性 

分 类 号：R644[医药卫生—外科学]