摘要
目的分析烧伤患者病原菌分布及耐药性变化,为感染防治提供参考。方法收集医院烧伤患者各类标本中分离的病原菌,对病原菌分布及药敏率进行统计分析。结果共分离病原菌1015株,其中革兰阴性菌637株,占62.76%,以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌、大肠埃希菌为主,分别占17.93%、12.32%、7.49%、6.60%;革兰阳性菌323株,占31.82%,以金黄色葡萄球菌、凝固酶阴性葡萄球菌、粪肠球菌为主,分别占16.35%、4.24%、3.15%,真菌55株,占5.42%,以白色假丝酵母菌、热带假丝酵母菌为主,分别占2.17%、1.38%;铜绿假单胞菌对头孢他啶、头孢哌酮/舒巴坦、亚胺培南耐药率分别为34.07%、40.66%,26.37%;鲍氏不动杆菌除对头孢哌酮/舒巴坦较敏感外,对其他抗菌药物广泛耐药;主要革兰阳性菌对常用抗菌药物耐药率普遍较高,但对利奈唑胺、替考拉宁、万古霉素仍保持敏感,耐药率<10.0%;多药耐药/泛耐药铜绿假单胞菌及耐碳青霉烯类/泛耐药鲍氏不动杆菌检出率呈明显上升趋势,耐甲氧西林金黄色葡萄球菌(MRSA)检出率呈下降趋势。结论主要病原菌多药耐药/泛耐药现象日益严重,临床应予以重视并合理使用抗菌药物。
OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria causing infections in burn patients so as to provide basis for the prevention and treatment of infections. METHODS The pathogenic bacteria isolated from specimens of burn patients were collected, then the distribution of the pathogens and the drug susceptibility rates were statistically analyzed. RESULTS Of totally 1015 strains of pathogenic bacteria isolated, there were 637 （62.76 %） strains of gram-negative bacteria, 323 （31.82%） strains of gram-positive bacteria, and the P seudornonas aeruginosa （ 17.93 % ）, Acinetobacter baunuznnii （ 12.32 % ）, K lebsiella pneurnanlae （7.49%） and Escherichia coli （6. 60%） were dominant among the gram-negative bacteria, the gram-positive bacteria composed mainly by Staphylococcus aureus （16.35 %） , coaguIase-negative Staphylococci （4. 24 %） and Enterococcus faecalis （3. 15%）; there were 55 （5. 42%） strains of fungi, among which Candida albicans （2.17%） and Candida tropicalis （1. 38%） were predominant. The drug resistance rates of P. aeruginosa to ceftazidime, cefoperazone/sulbactam and imipenem were 34. 07%, 40. 66%, and 26. 37%, respectively, the A. baurnannii was sensitive to cefoperazone/sulbactam but extensively resistant to other antibiotics, the drug resistance rates of major gram-positive bacteria to commonly used antibiotics were generally high, however, the gram-positive bacteria remained sensitive to linezolid, teicoplanin and vancomycin, with the resistance rates less than 10. 0%. The detection rates of multidrug-resistant/pandrug-resistant P. aeruginosa and carbapenems/ pandrug-resistant A. baurnannii showed an upward trend, and the detection rate of the methicillin-resistant S. aureus showed a downward trend. CONCLUSION The main species of pathogens isolated are increasingly multidrug- resistant or pandrug-resistant , it is necessary for the hospital to focus on the reasonable use of antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第22期5602-5604,共3页
Chinese Journal of Nosocomiology
关键词
烧伤
感染
耐药性
多药耐药
泛耐药
Burn
Infection
Drug resistance
Multidrug-resistance
Pandrug-resistance
