严重烧伤患者铜绿假单胞菌感染的临床分析与耐药性监测

Clinical characteristics of Pseudomonas aeruginosainfection in severe burns patients and analysis of drug resistance

目的探讨严重烧伤患者铜绿假单胞菌感染的临床特征以及耐药性,为临床治疗提供参考依据。方法选取2009年3月-2014年4月严重烧伤铜绿假单胞菌感染患者465例,对其感染部位进行统计,分离菌株进行体外耐药性监测并统计多药耐药菌的耐药模式,采用SPSS13.0软件进行统计分析。结果 465例严重烧伤铜绿假单胞菌感染患者以创面感染最为常见,共发生310例占66.67%,其次是呼吸系统和泌尿系统感染;465株铜绿假单胞菌对米诺环素的耐药性最高,耐药率为84.95%,其次是头孢噻肟、庆大霉素及妥布霉素;26株多药耐药菌株中对头孢吡肟+哌拉西林/他唑巴坦耐药最为常见,耐药率42.31%,其次是对头孢吡肟+阿米卡星耐药率19.23%。结论严重烧伤患者医院感染铜绿假单胞菌以创面感染为主,其次为呼吸系统及泌尿系统感染,应采取必要措施积极预防感染发生,一旦发生感染可以阿米卡星或哌拉西林/他巴唑坦联合除头孢吡肟外的其他抗菌药物进行早期治疗。

OBJECTIVE To explore the clinical characteristics of Pseudomonas aeruginosa infection in the severe burns patients and analyze the drug resistance so as to provide guidance for clinical treatment .METHODS A total of 465 severe burns patients with P .aeruginosa infection who were treated in the hospital from Mar 2009 to Apr 2014 were enrolled in the study ,then the infection sites were taken for statistics ,the in vitro drug resistance of the isolated strains was monitored ,the drug resistance modes of multidrug‐resistant strains were observed ,and the statistical analysis was performed with use of SPSS13 .0 software .RESULTS Of the 465 severe burns patients with P .aeruginosa infection ,310 had wound infection ,accounting for 66 .67% ,followed by the respiratory system in‐fection and the urinary system infection .The drug resistance rate of the 465 strains of P .aeruginosa to minocy‐cline was the highest （84 .95% ） ,followed by cefotaxime ,gentamicin ,and tobramycin .The drug resistance rate of the 26 strains of multidrug‐resistant P .aeruginosa to cefepime plus piperacillin‐tazobactam was 42 .31% ,and the drug resistant rate to cefepime plus amikacin was 19 .23% .CONCLUSION The wound infections are dominant a‐mong the severe burns patients with the P .aeruginosa infection ,followed by the respiratory system infection and urinary system infection .It is necessary to take prevention measures of the infections and choose amikacin or pip‐eracillin‐tazobactam combined with the antibiotics except for cefepime for early treatment of the infections .