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我院2013－2015年烧伤患者感染的病原菌分布及耐药性分析
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| 篇名： | 我院2013－2015年烧伤患者感染的病原菌分布及耐药性分析 |
| TITLE： | |
| 摘要： | 目的：了解我院烧伤患者感染的病原菌分布及耐药性，为临床合理使用抗菌药物提供参考。方法：采用简单随机抽样法选取2013年1月－2015年12月于我院就诊的烧伤患者389例，对其病原菌培养、鉴定及药敏试验结果进行回顾性分析。结果：我院389例烧伤患者共送检临床标本678份，有564份标本检出病原菌，阳性率为83.19％。共检出病原菌564株，其中革兰氏阴性菌367株（65.07％），以铜绿假单胞菌（158株）、大肠埃希菌（67株）、鲍曼不动杆菌（36株）和阴沟肠杆菌（31株）为主；革兰氏阳性菌177株（31.38％），以金黄色葡萄球菌（81株）、肠球菌属细菌（44株）和表皮葡萄球菌（26株）为主；真菌20株（3.55％），以白色假丝酵母菌（13株）为主。检出产超广谱β-内酰胺酶（ESBLs）大肠埃希菌42株（62.69％），产ESBLs肺炎克雷伯菌11株（40.74％）。革兰氏阴性菌对氨基糖苷类、β-内酰胺类、四环素类和头孢菌素类抗菌药物的耐药率均较高；铜绿假单胞菌对硫酸粘菌素敏感，大肠埃希菌、阴沟肠杆菌和肺炎克雷伯菌对亚胺培南敏感，鲍曼不动杆菌对美罗培南敏感，耐药率均为0。革兰氏阳性菌对大多数常用抗菌药物的耐药率均较高；金黄色葡萄球菌对万古霉素敏感，表皮葡萄球菌对万古霉素、替考拉宁和米诺环素敏感，耐药率均为0。白色假丝酵母菌和热带假丝酵母菌对两性霉素B、5-氟胞嘧啶的耐药率≤5％。结论：我院烧伤患者感染的主要病原菌为革兰氏阴性杆菌，以铜绿假单胞菌最为常见；主要病原菌的产酶情况和耐药情况较为严重。应进一步规范抗菌药物的临床使用，并根据病原学检查结果和患者临床症状合理选择抗菌药物。 |
| ABSTRACT： | OBJECTIVE： To investigate the pathogen distribution and drug resistance of burn patients in our hospital， and to provide reference for rational use of antimicrobial agents in the clinic. METHODS： 389 burn patients were selected from our hospital during Jan. 2013 to Dec. 2015 by simple random sampling， and then analyzed retrospectively in respects of pathogen culture， identification and the results of sensitivity tests. RESULTS： 678 clinical specimen were collected from 389 burn patients of our hospital， 564 strains of pathogens were detected， with positive rate of 83.19％. Of 564 pathogens， there were 367 stains of Gram-negative bacteria （65.07％）， mainly including Pseudomonas aeruginosa （158 strains）， Escherichia coli （67 strains）， Acinetobacter baumannii （36 strains）， Enterobacter cloacae （31 strains）； there were 177 strains of Gram-positive bacteria （31.38％）， mainly including Staphylococcus aureus （81 strains）， Enterococcus （44 strains） and Staphylococcus epidermidis （26 strains）； there were 20 strains of fungus （3.55％）， mainly including Candida albicans （13 strains）. There were 42 strains of ESBLs E. coli （62.69％） and 11 strains of ESBLs Klebsiella pneumoniae （40.74％）. Gram-negative bacteria were highly resistant to aminoglycosides， β-lactamase， tetracycline and cephalosporin. P. aeruginosa was sensitive to colistin sulphate. E. coli， E. cloacae and K. pneumoniae were sensitive to imipenem， A. baumannii was sensitive to meropenem， and their resistant rates were 0. Gram-positive bacteria were highly resistant to many common antimicrobial agents； S. aureus was sensitive to vancomycin， S. epidermidis sensitive to vancomycin， teicoplanin and minocycline， and their resistant rates were 0. Resistant rates of C. albicans and C. tropicalis to amphotericin B and 5-fluorocytosine were ≤5％. CONCLUSIONS： Main pathogen of infection in burn patients of our hospital is Gram-negative bacteria， mainly being P. aeruginosa. Producing enzymes and drug resistance of main pathogens are serious. It is necessary to standardize clinical application of antimicrobial agents and choose antimicrobial agents rationally according to etiological examination and clinical symptoms. |
| 期刊： | 2016年第27卷第35期 |
| 作者： | 严炯 |
| AUTHORS： | YAN Jiong |
| 关键字： | 烧伤；感染；病原菌；分布；耐药性 |
| KEYWORDS： | Burn； Infection； Pathogen； Distribution； Drug resistance |
| 阅读数： | 271 次 |
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