烧伤患者难愈性创面多重耐药菌回顾性分析

目的分析烧伤外科病房难愈性创面多重耐药菌（MDRO）定植感染情况，为临床感染防控提供依据。 方法对2012年1月至2017年12月中国人民解放军海军第九〇五医院烧伤外科住院患者难愈性创面的细菌学资料进行调查，回顾性分析MDRO的分布、检出率及特殊耐药情况。 结果难愈性创面分离出270株MDRO，其中革兰阳性菌128株（47.41%），革兰阴性菌142株（52.59%）。居前5位的MDRO依次为金黄色葡萄球菌（125株）、铜绿假单胞菌（56株）、大肠埃希菌（30株）、肺炎克雷伯菌（19株）和鲍曼不动杆菌（18株）。MDRO平均检出率为77.14%，以上前5位MDRO检出率分别为88.65%、65.12%、90.91%、100.00%和90.00%。特殊耐药菌株中，耐甲氧西林金黄色葡萄球菌共118株，碳青霉烯类耐药的铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌分别为42株、12株和5株。 结论烧伤外科病房难愈性创面MDRO分布广泛、检出率高，应采取有效的感染防控措施。

Retrospective analysis of multidrug resistance organism isolated from refractory wound in patients with burns

ObjectiveTo investigate the multidrug resistance organism (MDRO) isolated from refractory wound in burns surgery wards, and to provide reference for prevention and control of refractory wound MDRO infection. MethodsRefractory wound bacteriological data of patients who were treated in Burns Surgery Wards in the 905th Hospital of PLA Navy from January 2011 to December 2017 were collected. The distribution and detection rate of MDRO, specific drug resistance organism were analyzed, retrospectively. ResultsThere were 270 MDRO strains isolated from refractory wound, among which Gram-positive and Gram-negative MDRO accounted for 47.41% and 52.59%, respectively. The top five MDRO strains were Staphylococcus aureus (125 strains), Pseudomonas aeruginosa (56 strains), Escherichia coli (30 strains), Klebsiella pneumoniae (19 strains) and Acinetobacter baumannii (18 strains). The average detection rate of MDRO was 77.14%. The detection rate of the above top five MDRO were 88.65%, 65.12%, 90.91%, 100.00% and 90.00%, respectively. Among those MDRO, there were 118 strains of methicillin-resistance Staphylococcus aureus (MRSA), 42 strains of carbapenem-resistance Pseudomonas aeruginosa (CR-PA), 12 strains of carbapenem-resistance Acinetobacter baumannii (CR-AB) and 5 strains of carbapenem-resistance Klebsiella pneumoniae (CR-KP), respectively. ConclusionsMDRO isolated from refractory wound in burns surgery wards are diverse and the detection rates are high. Measures need to be strengthened for prevention and treatment of refractory wound MDRO infection.