烧伤创面感染病原菌分布及其耐药性研究

Study on the distribution and drug resistance of pathogens in the infectious burn wound

目的研究烧伤患者创面分泌物病原菌分布及其耐药性,为临床合理使用抗菌药物提供参考依据。方法采用细菌分离鉴定技术和药敏试验方法,对某医院280例患者烧伤创面分泌物病原菌进行检测与分析。结果280例患者烧伤创面分泌物中,检出病原菌者186例,检出率为66.43%。共培养出病原菌212株,革兰阴性菌占70.75%,革兰阳性菌占26.42%,真菌占2.83%。革兰阴性菌对常用抗菌药物均呈现不同程度耐药,仅对亚胺培南和美罗培南具有较高的敏感性;未检出革兰阳性菌对万古霉素、利奈唑胺和替考拉宁耐药菌株。结论该医院烧伤创面感染病原菌以革兰阴性杆菌为主,普遍产生耐药性,仅对碳青霉烯类抗菌药物敏感,提示应按照药敏试验结果选用抗菌药物,加强耐药监测,合理应用抗菌药物。

Objective To study the distribution and drug resistance of pathogens in burn wound secretions of the patients,to provide reference for rational use of antibiotics in clinics. Methods By bacterial isolation and identification,and susceptibility testing methods,we detected and analysed the pathogens in 280 cases of burn wound secretions in a hospital. Results From the 280 cases,186 cases of pathogens were detected,the detection rate was 66. 43%. 212 pathogens were cultured,Gram- negative bacteria accounted for 70. 75%,Gram- positive bacteria accounted for 26. 42%,fungi accounted for2. 83%. The drug resistance of Gram- negative bacteria to common antibiotics had shown varying degrees,they showed high sensitivity just to imipenem and meropenem. Gram- positive bacteria were not detected the resistance strains to vancomycin,linezolid and teicoplanin. Conclusion In this hospital from the burn wound infection,Gram- negative bacilli took up the most important part and they showed widespread drug resistance,only sensitive to carbapenems. We suggest that the choice of antimicrobial drugs should be in accordance with the results of drug susceptibility test.