烧伤患者创面细菌分布特点及耐药性分析

Distribution Characteristics and Drug Resistance of Wound Surface Bacteria in Patients with Burns

目的了解烧伤患者创面细菌的分布特点及其耐药情况。方法回顾性分析2012年1—12月昆明医科大学第二附属医院烧伤科患者创面分泌物标本,分析检出菌株的分布特点及耐药情况。结果检出率较高的前10种细菌革兰阴性菌为铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、奇异变形杆菌,革兰阳性菌为金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌、屎肠球菌,占总检出菌的86.63%,革兰阴性菌数量明显多于革兰阳性菌。其中耐甲氧西林金黄色葡萄球菌对大多数抗菌药物的耐药率达90%以上。结论烧伤病区创面细菌感染及耐药问题较为严重,需严格实施消毒隔离措施,加强抗菌药物的合理使用。

Objective To investigate the distribution characteristics and drug resistance of wound surface bacteria in patients with burns. Methods Bacteria isolated from wounds of patients with burns from 2012 January to December were retrospectively analyzed,and the distribution characteristics and drug resistance of detected strains were also analyzed. Results The top ten of detected bacteria were gram-negative bacteria of pseudomonas aeruginosa,acinetobacter baumannii,escherichia coli,klebsiella pneumoniae and enterobacter cloacae,and gram-positive bacteria of staphylococcus aureus,staphylococcus epidermidis,enterococcus faecalis and enterococcus faecium,which accounted for 86. 63% of total detected bacteria,and the amount of gram-negative bacteria was obviously larger than that of gram-positive bacteria. The drug resistance rate of Methicillin resistant S. aureus（ MRSA） to most of antibacterials exceeded 90% in all drugs except in vancomycin,linezolid and teicoplanin. Conclusion Bacterial Infections and drug resistance of wound surfaces are intensive in burns endemic area,so the disinfection and isolation measures should be strictly carried out,and the rational use of antibiotics should be strengthened.