15年来烧伤创面感染常见菌和抗生素敏感性的变化

Changes in Common Infective Pathogens from Burn Wounds and Susceptibility to Antibiotics for in Last Fifteen Years

目的 :总结 15年来烧伤创面细菌培养和药物敏感试验情况 ,以分析创面细菌菌株变化及抗生素敏感性变化规律。方法 :3 4 5例烧伤病人 ,分别于入院后 1周内及换药前不定期取创面分泌物或脓液标本 ,接种于血平皿 ,3 5℃培养 2 4h ,纯培养后常规鉴定 ,并用K B法进行体外药物敏感试验。结果 :3 4 5例病人中分离出 2 7种细菌 ,3种真菌 ,共 5 3 8株。其中革兰阳性菌占 49.3 % (金黄色葡萄球菌 173株 ,占 3 2 .2 % ) ,革兰阴性菌占 48.1% [铜绿假单孢菌 (绿脓杆菌 ) 15 2株 ,占2 8.3 % ]。结论 :1.烧伤创面感染细菌以金黄色葡萄球菌和铜绿假单孢菌为主 ,金葡菌感染更占优势 ;2 .耐药菌株增加 ,耐甲氧西林金黄色葡萄球菌 (MRSA)感染成为不容忽视的问题 ;3 .少见菌感染有增加的趋势 ;4.真菌感染是梅雨季节难以避免的问题 ;5 .

Objective The purpose of this work was to analyze the changes in strains from infected burn wounds and the sensitivity to antibiotics by summing up germiculture of secretion from the wounds and drug sensitive test.Methods The secretion or purulence from burn wounds of 345 patients hospitalized from 1984 to 1999 was taken within one week after admission and before changing dress.The secretion was inoculated and cultured at 35?℃ for 24 hours and identified routinely.And drug sensitive test by K B method was performed at the same time. Results 538 strains from 345 infected burn patients included 27 species of bacteria and 3 species of fungi.The positive rates of Gram positive and Gram negative germ were 49.3 % and 48.1%,respectively.Of all isolated pathogens,there were 173 strains (32.2%)of Staphylococcus aureus ,and 152 strains (28.3%) of Pseudomonas aeruginosa .Conclusions 1.The dominant bacteria from the infected wounds are Staphylococcus aureus and Pseudomonas aeruginosa ,with the positive rate of the former being highest;2.The attention should be paid to the increased susceptibility of bacteria to antibiotics and the infection with methicillin resistant staphy lococcus aureus(MRSA);3.The infection with some opportunistic pathogens and fungi was stressed;4.It is unavoidable for burn wounds to be effected by fungi in plum rain season;5.It is necessary to use antibiotics reasonably.