摘要
目的:探讨感染病原菌在烧伤创面愈合前的更替规律.方法:从1995年至2003年我院烧伤病区病原菌耐药数据库中选取病原菌检测三次以上,前后间隔大于1周的病例进行统计分析;以第1次检测的时间为起点,分别统计第1～6周(包括6周)检出并进行药敏试验的常见病原菌构成比,并比较1995～1997年、1998～2000年、2001～2003年三个阶段烧伤创面愈合过程中病原菌更替的异同.结果:金黄色葡萄球菌(金葡菌)、变形杆菌属、肺炎克雷伯菌的构成比随创面存在的时间延长而升高,特别是金葡菌,其构成比在各时间点均高于其它病原菌,在创面形成6周后达50%.肠球菌属、阴沟肠杆菌、不动杆菌的构成比随创面存在时间的延长而降低.与1995～2000年的前两个阶段相比,2001～2003年在创面病原菌中金葡菌、变形杆菌属和不动杆菌属的构成比均明显升高,而铜绿假单胞菌和大肠杆菌的构成比明显下降.结论:金葡菌是我院烧伤创面感染最主要的病原菌;在伤后不同的阶段均应重点防治该菌的感染;而变形杆菌属和肺炎克雷伯菌感染的防治重点应放在伤后4周以后;肠球菌属、阴沟肠杆菌、不动杆菌属感染的防治重点则应是伤后的早期.
Objective：To investigate the trend of alteration of pathogens in infected burn wound before healing. Methods：The data were collected and analyzed from the data bank of pathogens collected in a burn unit. Only the bacteria from patients who were found to have over 3 positive cultures and the drug resistance of the bacteria determined were included in this retrospective study. The interval between the first isolation and last one was usually larger than one week. The species ratios of common bacteria were calculated after 1, 2, 3, 4, 5 and over 6 weeks from the first isolation. Results：The isolateion rates of S. aureus, Proteus sp. and Klebsiella pneumoniae were increased with the prolonged existence of open wounds, and species ratio of S. aureus was the highest among all species of bacteria at all time points, reaching 50% in 6th week, but the species ratios of Enterococcus sp. , Enterobacter cloacae and Acinetobacter sp. declined. Compared with that of the period of 1995-1997 and 1998-2000,the species ratios of S. aureus, Proteus sp. and Acinetobacter sp. were increased significantly during the period of 2001-2003,and species ratios of Pseudomonas aeruginosa and E. coli were decreased during the same period. Conclusion：The results suggested that S. aureus was the prominent pathogen of infected burn wounds in our burn unit, and its infection might take place any time after injury. It was very likely that the majority infection by Enterococcus sp, and Acinetobacter sp. accurred at the early stage of burn injury, and infection by Proteus sp. and Klebsiella pneamoniae in burn wounds occurred several weeks later.
出处
《军医进修学院学报》
CAS
北大核心
2005年第4期302-303,共2页
Academic Journal of Pla Postgraduate Medical School
关键词
烧伤
细菌感染
burn
bacteria infection
