摘要
目的 对烧伤与创面修复外科患者进行常见感染病原菌及常见抗菌药物敏感性分析,为烧伤及各种创面感染患者治疗提供参考。方法 采集2019年3月至2021年3月烧伤与创面修复外科患者中创面分泌物标本共310份。选用法国生物梅里埃VITEK 2 Compact全自动微生物鉴定仪及VITEK MS全自动快速微生物质谱检测系统进行病原微生物的鉴定,采用纸片扩散法及仪器法对抗菌药物敏感性进行检测。使用WHONET 5.6软件分析病原菌的耐药性。结果310份送检标本中,共检出179例阳性标本,阳性率为57.74%。革兰阳性菌84例,占阳性标本数的46.93%,革兰阴性菌91例,占阳性标本数的50.84%,真菌4例,占阳性标本数的2.23%。其中革兰阴性菌以铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌与大肠埃希菌为主,革兰阳性菌以金黄色葡萄球菌为主。检出的革兰阴性菌中,铜绿假单胞菌对黏菌素、多黏菌素B、阿米卡星抗菌药物的敏感率> 80.40%;鲍曼不动杆菌对黏菌素、多黏菌素B、替加环素等抗菌药物的敏感率> 96.70%;肺炎克雷伯菌对替加环素、多黏菌素B抗菌药物的敏感率> 88.90%;大肠埃希菌对头孢替坦、阿米卡星、哌拉西林/他唑巴坦、碳青霉烯类抗菌药物的敏感率> 92.90%。检出的革兰阳性菌中,金黄色葡萄球菌对利奈唑胺、万古霉素、替加环素抗菌药物的敏感率可达100.00%。肠球菌对利奈唑胺、万古霉素、四环素抗菌药物的敏感率亦达到100.00%。结论 烧伤与创面修复外科患者创面感染的病原体主要为革兰阴性菌,对创面培养检出的菌种对于抗菌药物的敏感率不同,应当引起必要的关注。临床医师在治疗感染时,选用抗菌药物之前应留取细菌培养标本并正确送检,依据药物敏感试验结果选用抗菌药物,及早以明确治疗代替经验用药,达到抑制耐药菌株产生、提高抗菌药物治疗有效性的目的。
Objective To analyze the sensitivity of common pathogens and common antibiotics in burn and wound repair surgery patients, aiming to provide reference for the prevention and treatment of burn and various wounds. Methods From March 2019 to March 2021, 310 bacterial culture specimens of wound secretion from burn and wound repair surgery patients with suspected wound infection were collected. VITEK 2 Compact automatic bacterial identification instrument and VITEK MS automatic rapid microbial mass spectrometry detection system were used for pathogen identification. Disk diffusion method and instrumental method were employed to detect the antimicrobial susceptibility. The drug resistance of pathogens was analyzed by WHONET 5.6 software.Results Among 310 samples, 179 positive samples were detected, with a positive rate of 57.74%, 84 cases of Gram-positive bacteria, accounting for 46.93%, 91 cases of Gram-negative bacteria, accounting for 50.84% and 4 cases of fungi, accounting for 2.23%. Among them, Gram-negative bacteria were Pseudomonas aeruginosa(PAE), Acinetobacter baumannii(ABA), Klebsiella pneumoniae(KPN) and Escherichia coli(ECO). Staphylococcus aureus(SAU) was the main Gram-positive bacteria. Among the detected Gram-negative bacteria, the sensitivity rate of PAE to polymyxin B, myxin and amikacin was more than 80.40%. The sensitivity rate of ABA to myxin, polymyxin B and tegacyclin exceeded 96.70%. The sensitivity rate of KPN to tegacyclin and polymyxin B antibiotics was higher than 88.90%. The sensitivity rate of ECO to cefotetan, amikacin, piperacillin/tazobactam and carbapenem antibiotics was >92.90%. Among the detected Gram-positive bacteria, the sensitivity of SAU to linezolid, vancomycin and tetracycline was up to 100.00%, and that of Enterococcus to tetracycline, vancomycin and linezolid was also 100.00%. Conclusions Gram-negative bacteria are the main pathogens in patients with wound infection from Department of Burn and Wound Repair Surgery. Antibiotic susceptibility rate of these bacteria were differe
作者
刘延新
张伟
陈华夏
Liu Yanxin;Zhang Wei;Chen Huaxia(Department of Burns and Plastic Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)
出处
《新医学》
CAS
2022年第4期278-282,共5页
Journal of New Medicine
关键词
创面感染
病原菌
抗菌药物
药物敏感性
多重耐药菌
Wound infection
Pathogenic bacteria
Antibacterial drug
Drug susceptibility
Multidrug-resistant bacteria
