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目的:了解烧伤创面病原菌分布及耐药情况,为合理使用抗菌药提供依据。方法:对我科收治的671例烧伤患者创面分泌物933份进行病原菌培养及耐药性分析。结果:本次共检出病原菌标本614份,检出率为65.8%;共检出病原菌795株,其中革兰阴性菌498株(62.6%),革兰阳性球菌291株(36.6%),真菌6株(0.8%)。居前3位的菌株分别是鲍氏不动杆菌131株(16.5%),金黄色葡萄球菌128株(16.1%),铜绿假单胞菌126株(15.8%)。革兰阳性球菌金黄色葡萄球菌主要对青霉素G(98.4%)、氨苄西林(97.7%)及红霉素(89.1%)等产生耐药性;凝固酶阴性葡萄球菌主要对红霉素(88.2%)、青霉素G(81.5%)、氨苄西林(81.5%)及复方磺胺甲唑(81.5%)等产生耐药性。革兰阴性杆菌鲍氏不动杆菌对头孢曲松等12种抗菌药的耐药率均>90%,铜绿假单胞菌主要对头孢噻肟(75.4%)、庆大霉素(61.9%)及替卡西林/棒酸(50.8%)等产生耐药性,大肠埃希菌主要对氨苄西林(94.4%)、哌拉西林(84.7%)及复方磺胺甲唑(84.7%)等产生耐药性。结论:烧伤住院患者细菌感染以革兰阴性菌为主,鲍氏不动杆菌检出率居首位,且耐药性严重;对抗菌药的耐药性进行连续监测,可有效预防和控制感染。
Objective: To understand the distribution and drug resistance of pathogenic bacteria in burn wounds and to provide a basis for rational use of antibacterials. Methods: A total of 933 wounds from 671 cases of burns received in our department were tested for pathogen culture and drug resistance. Results: A total of 614 pathogenic bacteria were detected, with a detection rate of 65.8%. A total of 795 pathogens were detected, of which 498 (62.6%) were Gram-negative, 291 (36.6%) were Gram- 6 strains (0.8%). The top three strains were Acinetobacter baumannii 131 (16.5%), Staphylococcus aureus 128 (16.1%) and Pseudomonas aeruginosa 126 (15.8%). Gram-positive cocci Staphylococcus aureus mainly developed resistance to penicillin G (98.4%), ampicillin (97.7%) and erythromycin (89.1%), while coagulase-negative staphylococci were mainly resistant to erythromycin ), Penicillin G (81.5%), ampicillin (81.5%) and compound sulfamethoxazole (81.5%). Gram-negative bacillus Acinetobacter baumannii ceftriaxone and other 12 kinds of antimicrobial resistance rates were> 90%, Pseudomonas aeruginosa mainly cefotaxime (75.4%), gentamicin (61.9%), And ticarcillin / clavulanic acid (50.8%). Escherichia coli mainly developed resistance to ampicillin (94.4%), piperacillin (84.7%) and sulfamethoxazole (84.7%) Sex. CONCLUSIONS: Gram-negative bacteria are the main bacterial infections in hospitalized patients with burn, and Acinetobacter baumannii has the highest detection rate and serious drug resistance. The drug resistance of antibacterials is continuously monitored, which can effectively prevent and control infection .