烧伤感染的现状、对策与防治新动向

1 烧伤感染的现状2006年6月在昆山召开的第四届全国烧伤救治专题研讨会上,不同地区的烧伤中心或单位提供的微生物学调查资料中有不少共同点,其中很主要的一点就是:铜绿假单胞菌和金黄色葡萄球菌仍是烧伤检出菌中的主要细菌,也是我国近50年来大面积深度烧伤救治工作中难以清除的病原菌,不变中的变化是其耐药性不断增长。甲氧西林耐药金黄色葡萄球菌因被专门命名,人们对其认识较深刻,而革兰阴性杆菌耐药性的快速增长也不容忽视。革兰阴性杆菌对许多抗生素已由多重耐药性逐步发展为全耐药性;而且在多种新型抗生素的压力下,又筛选、激活了一些此前未被注意的机会致病菌。当前应特别注意的是鲍氏不动杆菌和嗜麦芽窄食单胞菌,它们正逐步成为医院感染的重要细菌。上述细菌毒力并非特别强,只因其存在天然耐药性,一旦过度繁殖,可能成为"无药可治"的难治菌。在此有必要强调,"医院感染"的含义是"患者住院后获得新的感

The present status, counter-measures and new trends on burn infection

In recent fifty years,Pseudomonas aeruginosa and Staphylococcus aureus were continuously the predominant in burn infections,the only change seen was a rapid increase in their drug-resistance.Under the pressure of antibiotics,Some opportunistic bacteria that were resistant to all available antibiot- ics emerged,such as Acinetobacter baumanii and Mahophilia stenotrophmonas.For critically burn patients,basing on early surgical intervention,early and short-term use of broad-spectrum antibiotic is advisable,and it may control the infection prompt- ly,prevent further inflammatory reaction,as well as minimize the emergence of antibacterial resistance.To control infections due to pandrug-resistant bacteria,cyclic use of some old antibi- otics may be helpful.In dealing with severe infection,a combi- nation of anti-pathogen and anti-inflammatory reaction measures should be considered.