重度烧伤患者呼吸道感染菌群分布情况及耐药性分析

Distribution and Drug Resistance of Bacteria in Severely Burned Patients with Respiratory Tract Infection

目的分析重度烧伤患者呼吸道感染菌群分布及耐药情况。方法选取2018年1月至2020年1月焦作煤业(集团)有限责任公司中央医院收治的84例重度烧伤合并呼吸道感染患者作为研究对象,根据患者具体病情取患者痰液、咽拭子或支气管肺泡灌液作为标本进行病原菌及药物敏感试验分析。结果84例患者共采集标本86份,分离出病原菌136株,其中革兰氏阴性菌96株(70.6%),尤以鲍曼不动杆菌(36株)、铜绿假单胞菌(30株)检出率(26.5%、22.1%)最高;革兰氏阳性菌35株(25.7%),尤以金黄色葡萄球菌(23株)检出率(16.9%)最高;真菌5株(3.7%),均为白色念珠菌。革兰氏阴性菌、革兰氏阳性菌及真菌均对万古霉素具有较高的敏感性,而对阿米卡星、氨曲南、头孢他啶等药物的耐药性不一,但基本都较高。结论重度烧伤患者呼吸道感染菌群以鲍曼不动杆菌等革兰氏阴性菌以及金黄色葡萄球菌等革兰氏阳性菌为主,且对多种抗菌药物均具有较高的耐药性。

Objective To analyze the distribution and drug resistance of bacteria in severely burned patients with respiratory tract infection.Methods Eighty-four severely burned patients with respiratory tract infection,admitted to the Central Hospital of Jiaozuo Coal Industry Group from January 2018 to January 2020,were selected as research subjects.According to the specific conditions of the patients,analysis of pathogenic bacteria and drug sensitivity test was conducted on the specimens of patients’sputum,throat swabs or bronchoalveolar lavage fluid.Results A total of 86 specimens were collected from the 84 patients,from which 136 strains of pathogenic bacteria were isolated.Among them,96 strains were Gram-negative bacteria(70.6%),with the highest detection rate in Acinetobacter baumannii(36 strains,26.5%)and Pseudomonas aeruginosa(30 strains,22.1%);35 strains were Gram-positive bacteria(25.7%),with the highest detection rate in Staphylococcus aureus(23 strains,16.9%);5 strains were Fungi(3.7%),all being Candida albicans.Gram-negative bacteria,gram-positive bacteria and fungi all showed a much high sensitivity to vancomycin,and they all have high drug resistance to amikacin,aztreonam,ceftazidime,etc.,but varied in degree.Conclusion The pathogenic bacteria in severely burned patients with respiratory tract infection are mainly Gram-negative bacteria,especially Acinetobacter baumannii,and Gram-positive bacteria,especially Staphylococcus aureus,and they all have much high drug resistance to multiple antibacterial drugs.