不同烧伤面积患者创面感染病原菌特点及耐药性研究  

Characteristics and drug resistance of pathogens in wound infection of patients with different burn areas

作　　者：白振宇 王健 Bai Zhenyu;Wang Jian(General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,Henan,China)

机构地区：[1]平煤神马医疗集团总医院,河南平顶山467000

出　　处：《临床心身疾病杂志》2024年第6期131-135,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的分析不同烧伤面积患者创面感染病原菌特点及耐药性,为临床诊治提供依据。方法对168例烧伤患者进行病原菌检测和药敏试验,统计总体病原菌检出情况,并分析不同烧伤面积患者病原菌检出情况及耐药性。结果168例烧伤患者,创面分泌物共培养出179株菌株,其中烧伤面积<10%(44例)、10%~49%(49例)、≥50%(75例)患者分别检出菌株47株、52株、80株。创面感染病原菌主要为革兰阴性菌(51.96%),其次为革兰阳性菌(48.04%),致病菌株以铜绿假单胞菌(27.37%)、金黄色葡萄球菌(22.91%)为主。烧伤面积<10%、10%~49%、≥50%的患者,主要致病菌分别为金黄色葡萄球菌(48.94%)、铜绿假单胞菌(25.00%)、铜绿假单胞菌(32.50%)。烧伤面积<10%的患者,铜绿假单胞菌对头孢他啶、头孢吡肟、妥布霉素耐药性较高;烧伤面积为10%~49%患者,铜绿假单胞菌对哌拉西林耐药性较高;烧伤面积≥50%的患者,铜绿假单胞菌对哌拉西林、亚胺培南、美罗培南耐药性高。不同烧伤面积患者,金黄色葡萄球菌对万古霉素、利奈唑胺无耐药性;烧伤面积<10%和10%~49%的患者,金黄色葡萄球菌对青霉素G耐药性较高;烧伤面积≥50%的患者,金黄色葡萄球菌对红霉素、克林霉素、青霉素G等多种抗菌药物耐药性较高。结论不同烧伤面积患者创面感染病原菌株存在差异,且随着烧伤面积增加,病原菌的耐药性增加。Objective To analyze the characteristics and drug resistance of pathogens in wound infection of patients with different burn areas in order to provide a basis for clinical diagnosis and treatment.Methods Detection of pathogens and drug sensitivity test were carried out in 168 burn patients,overall detection conditions of pathogens counted,and detection conditions and drug resistance of pathogens analyzed in patients with different burn areas.Results A total of 179 strains were cultured from the wound secretions of 168 burn patients,among them,47,52 and 80 strains detected in patients with burn area<10%(44 cases),10%、49%(49 cases)and≥50%(75 cases),respectively.The main pathogen in wound infection was gram-negative bacteria(51.96%),then gram-positive bacteria(48.04%),and pseudomonas aeruginosa(27.37%)and staphylococcus aureus(22.91%)were main pathogenic strains.Staphylococcus aureus(48.94%),pseudomonas aeruginosa(25.00%)and pseudomonas aeruginosa(32.50%)were the main pathogen in patients with burn area<10%,10%~49%and≥50%,respectively.The resistance of pseudomonas aeruginosa to ceftazidime,cefepime and tobromycin was higher in patients with burn area<10%;the resistance of pseudomonas aeruginosa to piperacillin was higher in patients with burn area 10%~49%;the resistance of pseudomonas aeruginosa to piperacillin,imipenem and meropenem was higher in patients with burn area≥50%.Staphylococcus aureus had no resistance to vancomycin and linezolid in patients with different burn areas;the drug resistance of staphylococcus aureus to penicillin G was higher in patients with burn area<10%and 10%~49%;the drug resistance of staphylococcus aureus to erythromycin,clindamycin,penicillin G and so on was higher in patients with burn area≥50%.Conclusion Pathogenic strains of wound infection in patients with different burn areas are different and the resistance of pathogens increases with the increase of burn areas.

关 键 词：烧伤 创面感染 病原菌 耐药性 

分 类 号：R826.5[医药卫生—临床医学] R181.32