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目的对烧伤感染患者的细菌分布及耐药性进行分析,为临床合理使用抗菌药物提供依据。方法收集烧伤感染患者创面分泌物,对标本作细菌的培养、分离鉴定以及药敏分析。结果 69例烧伤感染患者中共检出83株细菌,其中G~-杆菌54株(65.06%),G+球菌28株(33.73%),真菌1株(1.20%)。G~+球菌中金黄色葡萄球菌对头孢吡肟、头孢曲松、头孢噻肟耐药率达80.00%~86.67%,G~-杆菌中铜绿假单胞菌对头孢吡肟、丁胺卡那、头孢曲松、左氧氟沙星、头孢噻肟耐药率高达86.36%~95.45%,更严重的为鲍曼不动杆菌对丁胺卡那、头孢哌酮/舒巴坦、头孢曲松耐药率均高达100.00%。表皮葡萄球菌、大肠埃希菌和奇异变形杆菌耐药率相对较低。结论烧伤创面感染细菌以铜绿假单孢菌和金黄色葡萄球菌为主,多重耐药鲍曼不动杆菌引起的感染应高度重视,碳青霉烯类仍是革兰G~-杆菌感染的首选药物,G~+球菌对替考拉宁、复方磺胺甲噁唑、万古霉素敏感。罕见菌及真菌感染亦不能忽视。
Objective To analyze the bacterial distribution and drug resistance in patients with burn infection and provide evidences for the rational use of antibacterials in clinic. Methods The wound secretions of patients with burn infection were collected, and the bacteria were cultured, isolated and identified as well as the drug susceptibility analysis. Results A total of 83 strains of bacteria were detected in 69 patients with burn infection, including 54 (65.06%) of G ~ (-) bacilli, 28 (33.73%) of G + cocci and 1 (1.20%) of fungi. The drug resistance rate of Staphylococcus aureus to cefepime, ceftriaxone and cefotaxime in G ~ + cocci was 80.00% ~ 86.67%. The positive rate of Pseudomonas aeruginosa to cefepime and amikacin in G ~ , Ceftriaxone, levofloxacin, cefotaxime resistance rates as high as 86.36% to 95.45%, more serious Acinetobacter bifidobacterium to amikacin, cefoperazone / sulbactam, ceftriaxone resistance rates were Up to 100.00%. Staphylococcus epidermidis, Escherichia coli and Proteus mirabilis resistance rate is relatively low. Conclusions Bacterial infections in burn wounds are mainly Pseudomonas aeruginosa and Staphylococcus aureus, and multi-drug resistant Acinetobacter baumannii infection should be given high priority. Carbapenems are still the first choice of Gram-negative bacilli Drugs, G ~ + cocci on teicoplanin, sulfamethoxazole compound, vancomycin sensitive. Rare bacteria and fungal infections can not be ignored.