1993～1999年烧伤科细菌学调查及耐药性分析

An investigation of bacterial epidemiology and an analysis of bacterial resistance to antibiotics in a burn unit from 1993 to 1999

目的 研究笔者单位近几年细菌动态及耐药性 ,为临床诊治提供参考资料。 方法 对 1993～ 1999年本院烧伤科 784例患者的 345例次阳性创面细菌培养及药敏结果进行回顾性分析。 结果 (1)革兰阴性 (G-)杆菌占 5 6 .8% ,革兰阳性 (G+ )球菌占 39.4 % ,真菌占 3.8% ;(2 )金黄色葡萄球菌占G+ 球菌的 6 5 .4 % ,其中耐药甲氧西林金葡菌 (MRSA)的分离率 1993～ 1999年为 5 3 9% ,1998～ 1999年为 6 4 .3% ;铜绿假单胞菌占G-菌的 37.2 % ;(3)第三代头孢菌素表现了良好的抗菌活性 ,但耐药率有明显增加 ;(4)万古霉素和去甲万古霉素对MRSA无 1例耐药。 结论 本院烧伤科细菌感染仍以G-杆菌为主 ,G+ 球菌次之。第三代头孢菌素是目前的常用抗生素 ,但耐药率增加的问题不容忽视。MRSA分离率有逐年增高的趋势 。

Objective To investigate the bacterial epidemiology in our department in recent years, so as to provide assistance to the clinical management of burn patients. Methods A retrospective analysis was carried out with 345 bacterial cultures from burn wound and drug sensitivity results in 784 burn patients during 1993 to 1999 in our department. Results (1) Among all the bacteria, gram negative (G -) bacilli accouned for 56.8%, while gram positive ( G +) cocci and fungi in 3.8%. (2) Among all the G + cocci, 65.4% were Staphylococcus aureus, in which MRSA was identified in 53.9% during 1993 1999 and in 64.3% during 1998 1999. Pseudomonus aeruginosa accounted for 37.2% of all G - bacilli. (3) The 3rd generation of cephalosporins shew excellent anti bacterial capabilities, but the bacterial resistance to them increased significantly. (4) MRSA was very sensitive to both vancomycin and norvancomycin with no report of antibiotic resistance to them. Conclusion G - bacilli were still predominant bacteria in our burn department when compared to G + cocci. The 3rd generation cephalosporins are the routine antibiotics for the present. But resistant bacteria are on the increase. There are also more and more MRSAs isolated from burn wounds. For this, vancomycin and norvancomycin should be preferably used.