41例大面积烧伤并发肺部感染的菌群分析

Bacteriologic study of lung infection in 41 cases of heavy burns

目的了解大面积烧伤并发肺部感染的常见致病菌、传播途径及部分抗生素耐药率。方法从1988年1月￣2002年12月收治的大面积烧伤并发肺部感染的患者中,选择痰、血和创面分泌物培养均齐全的41例,对其细菌学特点、药物耐药性及肺部感染的传播途径进行总结分析。结果大面积烧伤并发肺部感染的致病菌G(r-)杆菌明显高于G(r+)球菌。部分肺炎可能源于血行传播。革兰氏阳性球菌对万古霉素、头孢霉素类等抗生素的耐药率较低。革兰氏阴性杆菌的耐药率较高。结论大面积烧伤并发肺部感染的患者致病菌与一般肺炎不同,其细菌学特点和对抗生素的耐药率对临床选用抗生素有参考价值。

[Objective] To study the frequent pathogenesis bacteria, transmission and resistant rate of antibiotics. [Method] The culture results of sputum, blood and wound secretions of 41 cases of bums with lung infection during 1988, 1-2002, 12 were analyzed. [Result] The isolation rates of Gr （-） bacteria from the 3 sources of culture were markedly higher than those of Gr （＋） cocci.Some cases of the heavy bums with pneumonia might be caused by the bacteria transmitted through blood. The resistant rate of antibiotics of Gr （＋） was high, while the Gr （＋） cocci were susceptible to Vancomycin and Cephalosporins. [Conclusion] The pathogenesis bacteria of heavy bums with lung infection are different from the common pneumonia. It＇ s bacteriological characters and the resistant rate of antibiotics may refer to the choice of antibiotics in clinic.