2001—2008年烧伤科临床分离的非发酵菌分布及耐药性分析

Analysis of drug resistance and clinical distribution of non-fermentative bacteria in burns department during 2001-2008

目的了解安徽医科大学第一附属医院烧伤科2001—2008年临床分离非发酵菌分布及细菌耐药情况,为临床合理使用抗菌药物、控制感染提供依据。方法对2001年1月至2008年12月入住本院烧伤病房且培养结果为非发酵菌患者的临床资料进行回顾性分析。结果 8年间共分离非发酵菌235株,以铜绿假单胞菌(75.3%)和鲍曼/溶血不动杆菌(14.0%)多见。从耐药性分析来看,铜绿假单胞菌对头孢曲松、头孢他啶、头孢噻肟、哌拉西林的耐药率分别为90.4%、95.5%、87.7%、100%。并且对亚胺培南的耐药率也达到了74.1%。而鲍曼/溶血不动杆菌对阿米卡星、头孢吡肟、亚胺培南的耐药率分别达到了90.6%、100%、50%。调查结果显示,创面感染率与烧伤程度具有显著统计学意义(χ2=13.014,P<0.05)。结论铜绿假单胞菌和鲍曼/溶血不动杆菌耐药性增加,主要与抗菌药物滥用有关,建议根据药敏结果合理选用抗菌药物。

Objective To analyze the distribution and drug resistance of non-fermentative bacteria which isolated from the first affiliated hospital of Anhui Medical University from 2001 to 2008 for guiding the clinical practice. Methods A retrospective analysis of non-fermentative bacteria in Burns Department from January 2001 to December 2008. Results 235 strains were isolated from burn patients. Pseudomonas aeruginosa（75.3%） and Acinetobacter baumannii（14.0%） were the dominant in the infections of non-fermentative bacteria. The resistant rates ofP aeruginosa to ceftriaxone, ceftazidime, cefotaxime and piperacillin were 90.4%, 95.5%, 87.7% and 100%, respectively. Especially the resistant rates of P aeruginosa to imipenem was up to 74.1%. Meanwhile the resistant rates of A.baumanni to amikacin, cefepime, imipenem were 90.6%, 100% and 50%, respectively. The results showed obviously that the wound infection has great relationship with the extent of burn in statistics（χ^2= 13.014, P〈0.05）. Conclusion The increase of drug resistance of Pseudomonas aeruginosa and Acinetobacter baumannii to antibiotics is mainly related to antibiotics abuse. So we suggest that antimicrobials should be used according to the result of susceptibility test.