摘要
我们调查了70年代初期和80年代中期上海瑞金医院烧伤创面的细菌生态学变化。结果表明80年代中期产气杆菌增加明显;70年代初期从未检出的阴沟杆菌已占痂下组织检出菌的3.06%;另一发现是耐甲氧西林的金黄色葡萄球菌已达73.4%。前者可能与常规外用磺胺嘧啶银与第三代头孢菌素的全身应用有关;后者可能与创面应用苯唑青霉素有关。
A comparative study of the ecology of the burn wound bacterial flora, during Jan. 1970 to Dec. 1971(Group Ⅰ) and Jan. 1985 to Dec. 1986 (Group Ⅱ) was carried out. The incidence of Gram positive cocci was 40.70% in Group Ⅰ versus 45.66% in Group Ⅱ. That of Gram negative bacilli was 54.92% and 48.10% respectively. The occurrence of Ps. aeruginosa was markedly reduced, in Group Ⅰ it reached 35.08% versus 11.26% in Group Ⅱ (P<0.001). The incidence of Enterobacter aerogenes was significantly increased, in Group Ⅰ it was only 3.69% but it accounted for 11.14% in Group Ⅱ(P<0.001). Before 1972, K. pneumonia and E. cloacae were seldom found on burn wounds, in Group Ⅱ, however, the incidence was 3.79% and 3.06% respectively. Acinetobacter anitratum occurred more often in Group Ⅱ than in Group Ⅰ, being 3.30% and 1.38% respectively (P<0.05). A total of 79 strains of Staphylococcus aureus were isolated from burn wounds, during Dee. 1986 to Nov. 1987. Among them Methicillin resistant Staphylococcus aureus (MRSA) accounted for 58 strains (73.4%) that is notable problem. In this centre 1% silver sulphadiazine has been used routinely since 1972 and third-generation cephalosporins have been used widely since 1983, these are the principle causes of the changing pattern of bacterial flora on the burn wounds.
