烧伤病房病原菌分布及耐药性分析

Distribution and Drug Resistance Analysis of Pathogenic Bacteria in Burns Wards

目的了解烧伤病房病原菌分布特点及其耐药性,指导临床用药。方法回顾性总结2012年1月-2013年12月本院收治的305例烧伤住院患者的病例资料,统计分析其感染病原菌的种类及药敏试验结果。结果检出的920株病原菌中,革兰氏阳性球菌441株(47.9%),主要包括凝固酶阴性葡萄球菌175株,金黄色葡萄球菌106株,肠球菌87株;革兰氏阴性杆菌472株(51.3%),主要包括鲍曼不动杆菌122株,铜绿假单胞菌78株,肺炎克雷伯菌73株,大肠埃希菌72株,变形杆菌属68株;真菌7株(0.8%)。其中,耐甲氧西林金黄色葡萄球菌的发生率为34.3%;非发酵菌耐药现象严重,对大多数药物的耐药率大于40.0%;肠杆菌科细菌耐药现象也较为严重,对三代、四代头孢菌素的耐药率均大于40.0%,对喹诺酮类药物的耐药率大于60.0%。结论烧伤病房病原菌耐药问题严重,应不断进行耐药性监测,合理使用抗菌药物。

Objective To understand the distribution characteristics and drug resistance of pathogenic bacteria in burns wards for the sake of guiding clinical medication. Me/hods The medical records of 305 burned patients admitted into our hospital between January 2012 and December 2013 were retrospectively concluded to analyze the types and drug sensitive test results of infectious pathogenic bacteria in a statistical way. Results 920 strains of pathogenic bacteria were tested, of which, 441 strains （47.9%） were gram positive cocci, mainly including 175 strains of coagulase negative staphylococcus, 106 strains of staphylococcus aureus and 87 strains of enterococcus; 472 strains （51.3%） were gram negative bacilli, mainly including 122 strains of acinetobacterbaumannii, 78 strains of pseudomonas aeruginosa, 73 strains of klebsiella pneu- monia, 72 strains of E. coli and 68 strains of proteus; and the left 7 strains （0. 8% ） were fungus. The occurrence rate of Methicillin-resistant staphylococcus aureus （MRSA） was 34. 3%. The drug resistance of non-fermentative bacteria was se- vere and the drug resistance rates of most of them were higher than 40.0%. The drug resistance of enterobacteriaceae bacte- ria was also more severe and their drug resistance rates to third-and fourth-generation cephalosporin and to quinolones were all higher than 40. 0% and 60. 0% respectively. Conclusion The drug resistance of pathogenic bacteria in burns wards was a serious problem, to which continuously monitoring should be performed for the reasonable application of antibacterial medications.