烧伤病区常见病原菌及其耐药性调查

Common Pathogens in Burn Wards and Their Drug Resistance

目的了解烧伤临床感染病原菌分布及耐药性情况。方法对2005年5月～2008年5月烧伤科送检的1216份标本的细菌培养和药敏结果进行回顾性分析。结果共检出627株病原菌，革兰阴性（G^-）杆菌占33．8％，革兰阳性（G^＋）球菌占48．8％，真菌占17．4％；鲍氏不动杆菌占8．6％；铜绿假单胞菌占6．0％；金黄色葡萄球菌占G^＋球菌77．5％，其中耐甲氧西林金黄色葡萄球菌（MRSA）的分离率为金黄色葡萄球菌的94．9％；药物敏感试验显示，各检出菌具有多药耐药性，G^＋菌对万古霉素敏感，G^-菌对亚胺培南敏感，但鲍氏不动杆菌仅对头孢哌酮／舒巴坦敏感。结论烧伤科细菌感染以G^＋球菌为主，G^-杆菌次之，其中鲍氏不动杆菌检出率有增多趋势，临床应重视细菌的药物敏感性，合理使用抗菌药物。

OBJECTIVE To know the pathogens distribution and resistance situation in the burn wards. METHODS A retrospective analysis was conducted to 627 pathogen isolates and sensitivity results, which submitted by burn department from May 2005 to May 2008. RESULTS Gram-negative （G ） bacilli occupied for 33. 8%, Grampositive （G＋ ） cocci occupied for 48. 8% and fungi occupied for 17.4%. Acinetobacter baumannii occupied for 8.6%, Pseudomonas aeruginosa occupied for 6.0%, Staphylococcus aureus occupied for 77.5%, in which the isolation rate of meticillin-resistant S. aureus （MRSA） was 94. 9%. The drug sensitivity tests showed that various detectable bacteria possessed multi-drug resistance; G＋ bacteria were sensitive to vancomycin, G- were sensitive to imipenem, but only A. baurnannii was sensitive to cefoperazone/sulbactam. CONCLUSIONS The bacterial infection in the burn department in our hospital mainly is due to G＋ cocci, then is G-bacilli, from which the A. baumannii detection rate is increasing. Clinicians should enhence to detect the sensitivity of bacteria and use antibiotics reasonably.