烧伤创面细菌学调查及耐药性分析

Bacteriological Investigation of Burn Wound and Drug-resistance Analysis

目的探讨烧伤创面感染细菌分布及耐药性情况,为临床诊治提供参考。方法对烧伤病房453例次阳性创面细菌培养及药敏结果进行回顾性分析。结果(1)革兰氏阴性(G-)杆菌占55.2%,革兰氏阳性(G+)球菌占40.2%,真菌占3.9%。(2)金黄色葡萄球菌占G+球菌的65.3%,其中耐药甲氧西林金葡菌(MRSA)的分离率为44.5%;铜绿假单胞菌占G-菌的39.2%。(3)第三代头孢菌素有良好的抗菌活性,但耐药率有明显增加。(4)万古霉素和去甲万古霉素对MRSA无l例耐药。结论本院烧伤病房细菌感染仍以G-杆菌为主,G+球菌次之。第三代头孢菌素是目前的常用抗生素,但耐药率增加的问题不容忽视。MRSA分离率有逐年增高的趋势,万古霉素和去甲万古霉素应作为首选用药。

Objective To study the bacteria distribution in burn wound infection and the drug - resistance. Methods A retrospective analysis was made to 453 positive bacterial cultures of the burn wounds and their drug - resistance. Results （ 1 ） Gram negative （G？） bacilli took up 55.2%, gram positive （G^＋ ） ccocci 40.2% and fungi 3.9% ; （2） Staphylococcus aureus took up 65.3% of the G ^＋ cocci, in which the isolate rate of MRSA was 44.5% ; Pseudomonus aeruginosa took up 39.2% of the G^＋ bacilli; （3） The third generation of cephalosporin had good antibacterial activity while the drug-resistance to it raised obviously; （4） No drug - resistance of MRSA was found to vancomycin and norvancomycin. Conclusions G^＋bacilli play the main part in bacterial infection of the burn wound, then is G^＋ cocci; the third generation of cephalosporin is the routine antibiotic but the drug- resistance to it keeps on raising; the isolate rate of MRSA is getting higher and higher yearly, vancomycin and norvancomycin may be the first -chosen antibiotic.