论文部分内容阅读
目的观察检测到多重耐药细菌的重度烧伤患者呼吸道与创面致病菌培养情况,并分析其药敏特征。方法重度烧伤患者13例,收集患者呼吸道与创面送检标本分离出的致病菌株共356株。收集13例患者的356株分离菌株分布情况及药敏试验结果并分析。结果分离的致病菌356株中,革兰阳性菌5株(1.4%),革兰阴性菌351株(98.6%)。革兰阴性菌中,最常见的致病菌是鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌和黏质沙雷菌,近80%的菌株为多重耐药或泛耐药菌株,对头孢菌素、碳青霉烯类和喹诺酮类几乎全耐药,仅部分菌株对复方磺胺、庆大霉素与丁胺卡那敏感。患者呼吸道与创伤面分离菌中存在耐碳青霉烯类肺炎克雷伯菌、耐碳青霉类阴沟肠杆菌和泛耐药鲍曼不动杆菌等多种多重耐药或泛耐药细菌交替感染;一个时间段内某个多重耐药菌株或泛耐药菌株可在不同患者间传播,并导致烧伤患者病情恶化甚至死亡。结论重度烧伤患者呼吸道与创面分离的致病菌绝大多数为革兰阴性菌,其中最常见的是鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌和黏质沙雷菌,多数为多重耐药或泛耐药菌株,且存在多种多重耐药或泛耐药细菌交替感染、传播的现象。
Objective To observe the culture of respiratory and wound pathogens in patients with severe burns with multi-drug-resistant bacteria and to analyze their drug-susceptibility characteristics. Methods Thirteen patients with severe burn were collected. A total of 356 pathogenic strains isolated from the respiratory tract and wound surface were collected. The distribution of 356 isolates from 13 patients and drug susceptibility test results were collected and analyzed. Results Among the 356 isolates isolated, 5 were Gram-positive bacteria (1.4%) and 351 were Gram-negative bacteria (98.6%). Gram-negative bacteria, the most common pathogens Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and Serratia marcescens, nearly 80% of the strains were multi-drug resistant Or pan-resistant strains, which are almost completely resistant to cephalosporins, carbapenems and quinolones, and only some strains are sensitive to sulfamethoxazole, gentamicin and amikacin. Patients with respiratory and traumatic surface isolates resistant to carbapenem-resistant Klebsiella pneumoniae, resistant to carbapenem-resistant Enterobacter cloacae and pan-resistant Acinetobacter baumannii and other multi-drug resistant or pan-resistant bacteria alternating Infected; a multidrug-resistant or pan-resistant strain can spread between patients over a period of time, leading to worsening and even death in a burn patient. Conclusion The majority of pathogenic bacteria isolated from respiratory tract and wound in patients with severe burn were Gram-negative bacteria, the most common ones were Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and visceral Serratia, the majority of multidrug-resistant or pan-resistant strains, and there is a variety of multi-drug-resistant or pan-resistant bacteria alternating infection, transmission phenomenon.