烧伤病房病原菌分布及耐药性分析

目的 分析烧伤病房病原菌分布、变化趋势与耐药情况.方法 回顾性分析该院烧伤病房2007年8月至2011年8月分离病原菌的菌群分布及耐药情况.结果 从烧伤患者中分离病原菌540株,以革兰阴性杆菌为主(60.4%),其中居首位者为铜绿假单胞菌(23.5%),其次为鲍曼不动杆菌(14.6%)、嗜麦芽假单胞菌(6.1%)、肺炎克雷伯菌(5.9%)、大肠埃希菌(3.1%)等;革兰阳性球菌占31.9%,居首位者为金黄色葡萄球菌(17.0%),其次为凝固酶阴性葡萄球菌(8.5%)和真菌(7.8%).鲍曼不动杆菌、大肠埃希菌、凝固酶阴性葡萄球菌和真菌有逐年增加的趋势.铜绿假单胞菌和鲍曼不动杆菌除对多粘菌素E的耐药率为0.0%外,对其他抗菌药物耐药率均大于30.0%;肺炎克雷伯菌和大肠埃希菌虽对碳青霉烯类抗生素保持0.0%的耐药率,但两菌产超广谱β-内酰胺酶(ESBLs)的比例高达87.5%和84.2%;革兰阳性球菌对多肽类抗菌药物和利奈唑胺虽保持100.0%敏感性,但耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的比例高达91.3%和95.5%.结论 该院烧伤病房主要病原菌为革兰阴性杆菌,对常用抗菌药物耐药情况严重,临床医生必须重视科学、合理应用抗菌药物,及时送检标本进行病原学检测及药敏试验,微生物实验人员应认真做好细菌耐药监测工作,为临床医生合理应用抗菌药物提供帮助.

Distribution and drug resistance of pathogenic bacteria in Burn Wards

Objective To investigate the distribution,variation tendency and drug resistance of pathogenic bacteria in Burn Bards.Methods Data of pathogen distribution and drug resistance of bacteria isolated from Burn Wards in this hospital from Aug.2007 to Aug.2011 were retrospectively analyzed.Results 540 strains of pathogenic bacteria were isolated from patients suffered empyrosis.Gram-negative bacteria were the main pathogens(60.4%),Isolation rate of Pseudomonas aeruginosa was the highest(23.5%),followed by Baumanii(14.6%),Pseudomonas maltophilia(6.1%),Klebsiella peumoniae(5.9%),Escherichia coli(3.1%).The proportion of Gram-positive bacteria were 31.9%,among which Staphylococcus aureus was with the highest isolation rate(17.0%),followed by coagulase negative Staphylococcus(8.5%).Isolation rate of fungus were 7.8%.Isolation rates of Baumannii,Escherichia coli,coagulase negative Staphylococcus and fungus were gradually increased year by year.Drug resistance rate of Pseudomonas aeruginosa and Baumannii to Polymyxin E were 0.0%,while to other antibiotics were over 43.0%.Drug resistance rates of Klebsiella peumoniae and Escherichia coli to carbopenems antibiotics remained 0.0%,but among these two kinds of bacteria,the detection rates of stains producing extended spectrum beta-lactamases(ESBLs) reached 87.5% and 84.2% respectively.Drug sensitivity of Gram-positive bacteria to polypeptide antibiotics and linezolid were 100.0%,but the detection rates of methicillin resistant Staphylococcus aureus(MRSA) and methicillin resistant coagulase negative Staphylococcus(MRCNS) reached 91.3% and 95.5%.Conclusion Gram-negative bacteria might be the main pathogen in Burn Wards of this hospital,and with serious drug resistance to commonly used antibiotics.Antibiotics should be scientifically and reasonably prescribed.Clinical samples should be sent for pathogenic analysis and drug susceptibility test in time.Drug resistance of clinical bacterial isolates should be monitored seriously by staffs of clinical microbiology laboratory to provide strong reference to clinical doctors for rational usage of antibiotics.