医院烧伤感染患者的病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing nosocomial infections in burn ward

目的了解医院烧伤感染患者的病原菌分布及耐药性。方法收集2009年1月-2011年12月烧伤病区住院患者的创面分泌物等标本中分离出的733株病原菌,对其菌种分布特点及耐药性进行分析,血标本采用BACTEC-9120血培养仪进行培养,菌种鉴定采用VITEK-2Compact细菌鉴定仪。结果共分离出非重复病原菌733株,其中革兰阴性菌569株占77.63%,分离率最高的3种病原菌分别为鲍氏不动杆菌、铜绿假单胞菌和肺炎克雷伯菌,均表现为多药耐药;3年中产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌检出率分别为72.41%和17.02%,革兰阳性菌中分离率最高为金黄色葡萄球菌,其中耐甲氧西林金黄色葡萄球菌(MRSA)在金黄色葡萄球菌中的平均检出率为70.37%,但均对万古霉素敏感。结论烧伤感染病原菌的耐药形势严峻,仍需加强病区菌种变化及药物敏感性的监测。

OBJECTIVE To study the distribution and drug resistance of the pathogens causing nosocomial infections in the patients of burn ward.METHODS A total of 733 strains of pathogens were isolated from the clinical specimens such as wound secretions which were obtained from the burn wards from Jan 2009 to Dec 2011,the distribution and drug resistance of the isolated pathogens were analyzed,the blood specimens were cultured with BACTEC-9120 blood culture system,and the bacterial identification was carried out by VITEK-2 Compact.RESULTS Of totally 733 strains of non-repetitive pathogens isolated,there were 569（77.63%） strains of gram-negative bacteria,among which the top three isolated species were Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumoniae,all the strains showed multidrug-resistant.The extended spectrum β-lactamase-producing Escherichia coli and K.penumoniae isolated within the three years accounted for 72.41%,and 17.02%,respectively.The isolation rate of the Staphylococcus aureus strains was the highest among the gram-positive cocci,and the average detection rate of the methicillin-resistant S.aureus was 70.37%,but all the S.aureus strains were sensitive to vancomycin.CONCLUSION The drug resistance is a serious problem in burn ward,thus,great attention should be paid to the monitoring of the change of the species as well as the drug susceptibility.