烧伤病房患者感染病原菌分布及耐药性分析

Pathogenic Bacteria Distribution and Drug Resistance in Inpatients of Burn Department

目的分析烧伤病房患者感染的病原菌分布及其耐药性,为临床合理选用抗菌药物提供依据。方法对2003-2006年从烧伤感染患者的各类标本中分离出的病原菌,采用纸片扩散法(K-B法)进行药物敏感试验,对病原菌耐药率进行分析。结果分离出的1325株病原菌中,革兰阴性(G-)杆菌846株,占63.85%,主要为铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌、阴沟肠杆菌和肺炎克雷伯菌;革兰阳性(G+)球菌464株,占35.02%,主要为金黄色葡萄球、肠球菌属和表皮葡萄球菌;真菌15株,占1.13%,主要为白色假丝酵母菌;病原菌抗药性强;耐甲氧西林金黄色葡萄球(MRSA)检出率为82.12%;肺炎克雷伯菌和大肠埃希菌的超广谱β-内酰胺酶(ESBLs)检出率分别为60.71%和41.89%。结论烧伤病房患者感染的病原菌以革兰阴性杆菌为主,主要致病菌常为多药耐药,加强其病原菌分布及耐药率监测,可指导临床合理用药和减少多药耐药菌产生。

OBJECTIVE To analyze the pathogenic bacteria distribution and drug resistance in inpatients of burn department, and instruct clinical application of antibiotics reasonably. METHODS Pathogenic bacteria were isolated from inpatients of burn department from 2003 to 2006. K-B slip diffusion method was taken to carry out the sensitive test. Rate of drug resistance of the pathogenic bacteria was analyzed. RESULTS Totally 1325 strains were isolated,among them 846 strains were Gram-negative bacteria, 464 strains were Gram-positive ones, and 15 strains were fungi. The percentage of these three groups was 63.85%, 35. 02% and 1. 13%, respectively. The main strains of the Gram-negative bacteria were Pseudomonas aeruginosa , Escherichia coli , Acinetobacter baumannii , Enterobacter cloacae and Klebsiella pneumoniae, and that of the Gram-positive bacteria were Staphylococcus aureus, Enterococcus and Staphylococcus epiderrnidis. The major strain of fungi was Candida albicans. The pathogenic bacteria tested showed high drug resistance. The detection rate of the meticillinresistanct S. aureus（MRSA） was 82.12%. The detection rate of the ESBLs from the K. pneumoniae and the E. coli was 60.17% and 41.89%. CONCLUSIONS It was showed that the major pathogenic bacteria infected of the inpatients of burn department are Gram-negative bacteria. The pathogenic bacteria are the multidrug-resistant ones. Enhanced monitoring on pathogenic bacteria distribution and drug resistance analyses among inpatients of burn department could benefit for the guide of clinical rational administration and depression of multidrug-resistant bacteria.