烧伤监护病房与普通烧伤病房创面细菌感染的临床与耐药性对比研究

Bacterial Resistance and Clinical Features of Wound Infection in Burned Patients in Intensive Care Unit vs in General Ward

目的通过对比烧伤重症监护病房(ICU)与同时间段内普通烧伤病房创面感染的临床资料和细菌耐药性,为防治提供依据。方法对2005年6、7月间发生于ICU和普通烧伤病房的19例、161例次(ICU4例、114例次,普通病房15例、47例次)创面感染的临床资料、细菌培养及体外药敏活性,进行回顾性地对照研究。结果ICU病房患者的易感性强,细菌构成以铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌为主;普通病房以金黄色葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌为主;ICU病房的铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌对部分抗菌药物的耐药情况较普通病房严重。结论ICU病房与普通病房的细菌构成、耐药率差异均有统计学意义,采取一定的消毒隔离措施,可有效阻断病原菌在不同病房间的传播。

OBJECTIVE To compare the bacterial resistance of wounds and clinical features in burned patients in intensive care unit （ICU） with those in general wards （GW） in the same period so as to provide basis for clinical prevention and treatment. METHODS Nineteen cases with wound infection admitted to the burn unit during June and July in 2005 were included in the retrospective study, 4 cases with 114 bacterial strains were from ICU and 15 cases with 47 bacterial strains were from GW respectively. The clinical features, bacterial culture and sensitivity test to antibiotics were analyzed. RESULTS Susceptibility to bacterial infection in ICU patients was significant than those in GW. The prevalent bacterial strains in ICU were Pseudomonas aeruginosa （PAE）, Staphylococcus aureus （SAU） and Acinetobacterbaurnannii （ABA）. In contrast, SAU, ABA, Klebsiella pneurnoniae （KPN） and PAE prevailed in GW. Drug resistance of PAE, ABA and KPN to some kinds of antibiotics in ICU was severer than those in GW. CONCLUSIONS There is relatively great difference in bacterial constitution and drug resistance ratio between ICU and GW. To take certain disinfection and isolation measures could effectively prevent bacterial strains from transmitting among the wards.