五年来烧伤感染创面菌群分布及其药物敏感性分析

An investigation of bacterial distribution of burn infection wound and their sensitivity to anti microbial agents in recent five years

目的 分析烧伤感染创面菌群分布及细菌耐药性变迁。方法 对 1998-2 0 0 2年间我院烧伤病人创面分泌物作细菌培养与鉴定 ,同时进行体外药物敏感试验。结果 创面细菌培养共检出 2 1种细菌 5 72株 ,金黄色葡萄球菌占 3 3 .74%(其中MRSA占 94.7%) ,铜绿假单孢菌 18.7%,金黄色葡萄球菌对万古霉素的敏感率为 94.4%;铜绿假单孢菌对亚胺培南、头孢他啶及特治星的敏感率分别为 81.6%、67.2 %及 79.5 %。结论 ( 1)本病区烧伤创面分离菌中G+ 球菌所占比例上升 ,金黄色葡萄球菌比例逐年增加 ,铜绿假单孢菌相对减少 ;( 2 )创面真菌感染增加 ;( 3 )由于产ES BLs菌株的出现 ,烧伤感染病原菌对第三代头孢敏感性下降 ,这种情况可选用碳青霉烯类及含酶抑制剂的联合制剂。( 4 )万古霉素仍然是治疗严重MRSA感染的首选药物。

Objective In order to analyze the bacterialdistribution on burn infection wound and their drug resistance.Methods The bacteria in excretions collected from burn wound of patientsfrom 1998-2002 were cultivated and identified,and their drug sensitivity were analyzed.Results 572 strains were identified to be of 21 species.The proportion of S.aureus was 33.7%,and 94.7 of it was MRSA;and the proportion of P.aeruginosa was 18.7%.Sensitivity rate of S.aureus to vancomycin was 94.4%,and that of P.aeruginosa to imipenem,ceftazidime and tazocin were 81.6%,67.2%and 79.5% respectively.Conclusion The proportion of G + cocci on burn wound had raised,and S.aureas had increased yearly while P.aeruginosa had relatively reduced.The infection of fungi had increased.With the incrdase of the strains that produce ESBLs,the sensitivity of pathogenetic bacteria to the third generation of cephalosporins fell,carbapenem and compound andtibiotics containing β-lactamase-inhibitor shoud be used for certain clinical need. Vancomycin is still the first choise to treat severe MRSA in fection. [