济源市人民医院烧伤科患者病原菌分布特点及抗菌药物使用情况分析

Analysis of the Use of Antibacterial Drugs and the Distribution of Pathogenic Bacteria in Patients of Burns Department of People's Hospital of Jiyuan

目的研究济源市人民医院烧伤科患者的病原菌分布特点,分析其抗菌药物使用情况。方法将2013-2015年济源市人民医院烧伤科收治的375例烧伤患者作为研究对象,每周收集1次创面分泌物进行细菌培养,对其中检出的部分细菌做抗菌药物敏感性检测,并对部分抗菌药物的使用情况予以分析。结果 2013-2015年病原菌阳性检出率呈逐年下降趋势;铜绿假单胞菌对阿米卡星、氨曲南、庆大霉素、亚胺培南、左氧氟沙星、美罗培南及妥布霉素等抗菌药物的敏感性呈逐年增高趋势,对头孢替坦、头孢曲松及头孢唑啉则呈现出较高的耐药性;鲍曼不动杆菌对一、二代头孢菌素及环丙沙星等抗菌药物的耐药性较高,对亚胺培南、阿米卡星、美罗培南等抗菌药物的敏感性较高;金黄色葡萄球菌与表皮葡萄球菌对克林霉素和红霉素的耐药性较高,对其他抗菌药物的敏感性较高;环丙沙星、头孢吡肟、头孢他啶、庆大霉素及四环素的使用强度呈逐年下降趋势,而左氧氟沙星与利奈唑胺的使用强度则呈逐年升高趋势。结论医生在治疗过程叶中,应遵循早期、联合、足量的用药原则,根据药物敏感试验结果进行抗感染治疗;医院应高度重视感染的控制工作,定期开展感染隐患排查,结合病原菌分布特点,及时阔整抗菌药物使用强度,以减少和避免耐药菌的产生。

Objective To observe the use of antibacterial drugs and the distribution of pathogenic bacteria in pa- tients of Burns Department of Peple ＇ s Hospital of Jiyuan. Methods 375 burns patients admitted to the Burns Department of People＇ s Hospital of Jiyuan between 2013 and 2015 were chosen as study subjects. Their wound secretion was collected every week for bacterial culture. Antibacterial drug susceptibility test was conducted on detected bacteria and the use of anti- bacterial drugs was analyzed. Results The positive detection rate of pathogenic bacteria was decreasing from 2013 to 2015 ; The susceptibility of pseudomonas aeruginosa to antibacterial drugs was increasing, like amikacin, aztreonam, gentamicin, imipenem, and levofloxacin, meropenem and tobramycin; It showed high drug resistance to cefotetan, ceftriaxone and ce- fazolin; Acinetobacter baumannii showed a high drug resistance to antibacterial drugs like ciprofloxacin and first and second generation cephalosporin; it showed high susceptibility to antibacterial drugs like imipenem, amikacin and meropenem. Staphylococcus anreus and Staphylococcus epidermidis have a high resistance to Clindamycin and Erythromycin, and high susceptibility to other antibacterials ; The use of Ciprofloxacin, Cefepime, Ceftazidime, Gentamicin, and Tetracycline is re-dueed year by year, while the use of Levofloxacin and Linezolid is increased. Conclusion During the treatment, doctors should prescribe medicine following the principle of early administration, adequate amount, combination drug therapy, and should treat infection based on the results of drug sensitivity test ; hospitals should pay high attention to infection control, regularly carry out hidden infection identification and adjust the intensity of antibacterial use based on the distribution of pathogenic bacteria so as to prevent the emergence of drug-resistant bacteria or to reduce its population.