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目的:分析粤北地区烧伤病房细菌密度与创面愈合的相关性。方法:选取2014年6月至2015年6月粤北人民医院专科收治的72例Ⅱ度烧伤患者,随机分为普通病房组和层流病房组各36例,均进行创面细菌培养和空气细菌培养及药物敏感试验,比较两组病人创面及空气培养病原菌种类、耐药率及与创面愈合时间的差异。结果:72例患者送检标本分离出病原菌111株,普通病房组阳性病原菌为61.67%明显高于层流病房组41.18%(P<0.05);同期层流病房空气阳性菌株为7.27%明显低于普通病房空气阳性菌株20.00%(P<0.05);两组病人创面及空气培养主要菌株类型为铜绿假单胞菌、金黄色葡萄球菌,其次为鲍氏不动杆菌、大肠埃希菌,组间比较,差异无统计学意义(P>0.05);普通病房组复方新诺明、青霉素、红霉素、克林霉素、利奈唑烷、万古霉素、利福平、呋喃妥因耐药率依次为94.59%、91.89%、91.89%、81.08%、81.08%、72.97%、70.27%、62.16%均显著高于层流病房组耐药率(P<0.05),苯唑西林耐药率略高于层流病房组,差异无统计学意义(P>0.05);层流病房组创面愈合时间(38.77±14.26)d,普通病房组创面愈合时间为(50.69±10.61)d,组间比较,差异具有统计学意义(P<0.01)。结论:粤北地区烧伤病房普通病房比层流病房空气中病原菌占比更高,细菌密度更大,而且普通病房组创面培养阳性率高于层流病房组,细菌密度与耐药率、创面愈合时间呈正相关,故应扩大层流病房普及率,采取一定的隔离、抗菌措施阻断病原菌传播,降低病房空气中病原菌密度。
Objective: To analyze the correlation between bacterial density and wound healing in burn wards in northern Guangdong. Methods: Seventy-two patients with grade Ⅱ burn who were admitted to Yuebei People’s Hospital from June 2014 to June 2015 were randomly divided into general ward group and lamina-flow ward group with 36 cases each. The wound bacterial culture and air bacterial culture And drug sensitivity test. The types of wound surface and airborne pathogens, drug resistance rate and wound healing time were compared between the two groups. Results: A total of 111 strains of pathogens were isolated from 72 samples. The prevalence of positive pathogens in common ward group was 61.67%, which was significantly higher than that in laminar flow ward group (41.18%, P <0.05). The air positive strain in laminar flow ward was 7.27% (P <0.05). The main strains of wound and air culture in two groups were Pseudomonas aeruginosa and Staphylococcus aureus, followed by Acinetobacter baumannii, Escherichia coli, (P> 0.05). The resistance rates of cotrimoxazole, penicillin, erythromycin, clindamycin, linezolid, vancomycin, rifampicin and nitrofurantoin in general ward were 94.59%, 91.89%, 91.89%, 81.08%, 81.08%, 72.97%, 70.27%, 62.16% were significantly higher than those in laminar flow ward (P <0.05) The difference was not statistically significant (P> 0.05). The wound healing time was (38.77 ± 14.26) days in the laminar flow ward group and (50.69 ± 10.61) days in the ward group, with statistically significant difference Significance (P <0.01). Conclusion: The prevalence of pathogenic bacteria in burned ward in northern Guangdong was higher than that in laminar flow ward, and the bacterial density was higher. The positive rate of wound culture in common ward group was higher than that in laminar flow ward group, the bacterial density and drug resistance rate, wound healing Time is positively correlated, it should increase the prevalence of laminar flow wards, to take a certain isolation, antibacterial measures to prevent the spread of pathogens, reduce the density of pathogenic bacteria in the ward air.