2011～2013年宁夏某院烧伤科病原菌分布及耐药性分析

Distribution and drug resistance of pathogens in burn department of a hospital in Ningxia from 2011 to 2013

目的了解宁夏医科大学总医院烧伤科2011~2013年临床病原菌分布及抗菌药物耐药情况,为有效指导临床用药、控制感染提供依据。方法 对2011年1月至2013年12月烧伤科送检阳性标本的细菌培养结果及药敏结果进行回顾性统计分析。结果 临床共分离出病原菌2 587株,其中革兰阴性菌832株（32.1%）,分离率居前3位的病原菌为阴沟肠杆菌、鲍曼不动杆菌和大肠埃希菌,分别占9.3%、6.4%、5.2%;阴沟肠杆菌对氨苄西林、头孢唑啉、哌拉西林、头孢西丁及复方磺胺甲噁唑的耐药率分别为62.9%、100.0%、37.5%、100.0%、98.3%;鲍曼不动杆菌对大部分抗菌药物的耐药率达到60.0%以上;大肠埃希菌对氨苄西林、阿米卡星、左旋氧氟沙星的耐药率分别为91.8%、4.1%、56.8%。革兰阳性菌1 728株占66.8%,分离率最高病原菌分别为金黄色葡萄球菌和表皮葡萄球菌,分别占21.5%、9.4%;金黄色葡萄球菌对大部分抗菌药物的耐药率达70.0%以上;表皮葡萄球菌对大部分抗菌药物的耐药率达40.0%以上。真菌27株（1.1%）,以白假丝酵母菌为主。结论 医院烧伤科患者存在混合感染,病原菌主要以金黄色葡萄球菌为主,病原菌对常用抗菌药物的耐药率较高,且存在多重耐药情况,因此需加强对烧伤科耐药细菌的监测,指导临床合理使用抗菌药物。

Objective To explore the distribution and drug susceptibility of pathogens causing infections of the patients in the burn department so as to guide reasonable use of antibiotics and control bacterial infection effectively.Methods To analyze retrospectively the distribution characteristic and drug resistant status of bacterial with positive result of bacterial culture in burn department from Jan 2011 to Dec 2013.Results A total of 2 587 strains of pathogens were isolated from the patients of burn department,there were 832（32.1%）strains of gram-negative bacteria,among which the top three isolated species were Enterobacter cloacae（E.cloacae）,Acinetobacter baumannii（E.baumanni）and Escherichia coli（E.coli）,accounting for 9.3%,6.4%,5.2% respectively.The drug susceptibility rates of the E.cloacaeto ampicillin,cefazolin,piperacillin,cefoxitin and compound sulfcmethoxazole were 62.9%,100.0%,37.5%,100.0%,98.3%,respectively.The drug resistance rate of A.baumannii to most antimicrobials were over60.0%.The drug susceptibility rates of the E.coli to ampicillin,amikacin,levofloxacin were 91.8%,4.1%,56.8%,respectively.There were 1 728（66.8%）strains of gram-positive bacteria,among which the highest isolated pathogens were Staphylococcus aureus（S.aureus）and Staphylococcus epidermidis（S.epidermidis）,accounting for 21.5%,9.4%,respectively.The drug resistance rate of S.aureus to most antimicrobials were more than 70.0%.The drug resistance rate of S.epidermidis to most antimicrobial were more than 40.0%.There was 27（1.1%）strains of fungi,among which the main pathogens was Candidaalbicans.Conclusion There are a variety of infection in the patients of burn department,the main pathogens was Staphylococcus aureus,the drug resistance rates of the pathogens to the commonly used antibiotics in the burn department are high,and most strains shows multi-drug resistance.Therefore,it is necessary to strengthen the monitoring of the drug resistance and guide the use of antibiotics.