摘要
目的分析烧伤患者创面感染的主要病原菌及其耐药性情况，为临床合理使用抗菌药物提供参考。方法回顾性分析326例烧伤患者创面分泌物培养获得的病原菌及耐药性。结果其分离培养病原菌213例，其中革兰阴性菌（G^-）131例（61．50％），革兰阳性菌（G^＋）73例（34．27％），真菌9例（4．23％）。G^-主要为铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌等；G^＋主要为金黄色葡萄球菌、溶血性链球菌、粪肠球菌；真菌主要为白色念珠菌，曲霉菌等。药敏结果显示，主要G^-对亚胺培南耐药率最低，其次为头孢哌酮舒巴坦、哌拉西林他唑巴坦、阿米卡星等；主要G^＋对万古霉素、替考拉宁耐药率最低，其次为哌拉西林他唑巴坦、夫西地酸、头孢拉定等；真菌对两性霉素B、伏立康唑等均较为敏感。结论烧伤后创面感染以革兰阴性菌为主，其次为革兰阳性菌，真菌较少见。其中铜绿假单胞菌、鲍曼不动杆菌、粪肠球菌耐药最为严重，临床需根据药敏结果予以合理的抗感染治疗方案，同时应加强烧伤患者病原菌流行病学和耐药性的监控，以控制细菌感染和耐药菌株的扩散。
Objective To analyze the pathogens distribution and drug resistance in patients on burn wounds infections in the hospital, so as to provide appropriate clinical treatment. Methods By retrospective analysis of 326 cases of pathogens distribution and drug resistance in patients on burn wounds infections. Results A total of 213 strains of pathogenic bacteria were isolated, wherein, gram-negative （ G ） bacteria strains 131, accounting for 61.50 %, gram-positive bacteria strains 73, accounting for 34.27 %, and fungus stralns 9, accounting for4.23 %. The results of drug sensitivity test showed that main gram negative bacteria were most sensitive to imipenem, and then Cefperazone-Sulbactam, aztreonam and Tazobactam, amikacin; gram positive were most sensitive to vancomycin, then teicoplanin, aztreonam and tazobactam, cefradine and so on. Fungus to amphotericin B, voriconazole, etc were more sensitive. Conclusion In all the pathogens of bum wounds infections, G- is the majority, then gram-positive bacilli and fungus. In all of pathogens, Pseudomonas aeruginosa, acinetobacter baumannii, dung enterococcus resistant are most serious. Attention are needed in clinical practice to monitor the drug resistance in order to control the bacterial infection and the spread of antimicrobial agents.
出处
《浙江临床医学》
2017年第3期495-497,共3页
Zhejiang Clinical Medical Journal
关键词
病原菌
烧伤创面感染
抗菌药物
耐药性
Pathogenic bacterium Burn wound infection Antimicrobial agents Drug resistance
