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目的:通过近年来烧伤病区革兰阳性(G~+)球菌构成比的增加,说明抗 G~+球菌感染的重要性,探讨头孢硫脒(仙立素)在抗 G~+球菌感染的作用。方法:调查1995年至2001年三0四医院烧伤病区病原菌流行病学变化,观察 G~+球菌的变化趋势。汇总七家医院198例烧伤病人对头孢硫脒的临床验证结果,以头孢呋辛钠作为对照组,并进行了体外敏感试验,评估头孢硫脒对 G~+球菌的抗感染作用。结果:三0四医院烧伤病区共检测出病原菌2584株,1999年开始 G~+球菌构成比明显增加,高达51.48%,金黄色葡萄球菌占总检出菌的31.30%,MRSA 占金黄色葡萄球菌的73.74%,从而证明了 G~+球菌已成为烧伤病区病原微生物的优势菌群。临床观察的头孢硫脒组比头孢呋辛组疗效好,表现在:①病人体温转为正常的时间短(4.68d 对照组为5.17d);②临床感染症状控制或减轻总显效率高达88.46%(对照组为76.47%);③创面细菌清除率为77.24%(对照组为56.92%);④G~+球菌体外药敏试验显示头孢硫脒的敏感率达到89.89%,仅次于万古霉素(99.36%)。结论:近年来 G~+球菌已成为许多单位烧伤病区细菌构成比的优势菌群,头孢硫脒对 G~+球菌的抗感染作用仅次于万古霉素,可作为临床抗 G~+球菌感染的第一线首选药物。
OBJECTIVE: To investigate the importance of cefathiamidine (ceftazidime) against G ~ + cocci infection by increasing the proportion of Gram-positive (G ~ +) coccus in the burn area in recent years. effect. Methods: The epidemiological changes of pathogenic bacteria in three hundred and forty-four hospital burns ward from 1995 to 2001 were investigated, and the changing trend of G ~ + cocci was observed. The clinical validation of cefathiamidine in 198 burn patients in seven hospitals was summarized. Cefuroxime sodium was taken as the control group, and in vitro sensitivity tests were conducted to evaluate the anti-infective effect of cefathiamidine on G ~ + cocci. Results: A total of 2584 pathogenic bacteria were detected in 300 burned areas in the 304 hospitals. The compositional ratio of G ~ + cocci increased significantly from 51.48% in 1999 to 31.30% of the total inoculated S. aureus. MRSA accounted for the golden yellow grape 73.74% of cocci, which proved that G ~ + cocci has become the dominant flora of pathogenic microorganisms in burn wards. Clinical observation of cefathiamidine group than the cefuroxime group curative effect, manifested in: ① patients to normal body temperature short time (4.68d control group was 5.17d); ② symptoms of clinical symptoms or reduce the total effective rate was as high as 88.46% (76.47% in the control group). The bacterial clearance rate was 77.24% (56.92% in the control group). In vitro susceptibility test showed that the sensitivity of cefathiamidine reached 89.89%, second only to vancomycin 99.36%). Conclusion: In recent years, G ~ + cocci has become the dominant bacterial flora of many burn units in China. Cefathiamidine is second only to vancomycin against G ~ + coccus, which can be used as clinical anti-G ~ + The first line of infection is the drug of choice.