论文部分内容阅读
目的了解烧伤病房病原菌分布及耐药情况,为临床经验性应用抗菌药提供指导依据。方法采集2011年11月至2014年10月该院收治的1 057例烧伤患者样本进行细菌培养。用VITEK2进行鉴定,K-B法进行药敏试验。选择万古霉素、头孢哌酮舒巴坦、左氧氟沙星、利福平、亚胺培南等常用抗菌药进行药敏试验。结果共分离出820株菌株,其中革兰阳性菌308株(37.56%),以金黄色葡萄球菌为首,为175株(21.34%);革兰阴性菌512株(62.43%),以鲍氏不动杆菌为首,为167株(20.37%),其次为铜绿假单胞菌115株(14.02%)。药敏试验结果显示,金黄色葡萄球菌较为敏感的药物为万古霉素、替考拉宁、替加环素、利奈唑胺,对氨基糖苷类及喹诺酮类的耐药率均在80%以上。铜绿假单胞菌对头孢类和碳青霉烯类耐药均在70%~80%,并且有泛耐药菌株产生。鲍氏不动杆菌除部分对替加环素敏感外,对其他抗菌药均广泛耐药。结论该院烧伤病房耐药情况严重,尤其是泛耐药鲍氏不动杆菌和铜绿假单胞菌的出现,应引起重视。
Objective To understand the distribution and drug resistance of pathogenic bacteria in burn ward, and to provide guidance for the clinical application of antibacterials. Methods A total of 1 057 cases of burn patients admitted to our hospital from November 2011 to October 2014 were collected for bacterial culture. Identification with VITEK2, K-B method for susceptibility testing. Select vancomycin, cefoperazone sulbactam, levofloxacin, rifampicin, imipenem and other commonly used antimicrobial susceptibility testing. Results A total of 820 strains of Klebsiella pneumoniae were isolated, of which 308 (37.56%) were Gram-positive bacteria, 175 (21.34%) were Staphylococcus aureus and 512 (62.43%) were Gram-negative bacteria. Acinetobacter led by 167 (20.37%), followed by Pseudomonas aeruginosa 115 (14.02%). Drug sensitivity test results show that the more sensitive drug Staphylococcus aureus vancomycin, teicoplanin, tigecycline, linezolid, aminoglycosides and quinolones resistance rates were more than 80%. Pseudomonas aeruginosa cephalosporins and carbapenem resistance are 70% to 80%, and pan-resistant strains. Acinetobacter baumanii in addition to some of the sensitivity of tigecycline, the other antimicrobial agents are widely resistant. Conclusion The hospital wards resistance was serious, especially the emergence of pan-resistant Acinetobacter baumannii and Pseudomonas aeruginosa, which should be paid more attention to.