烧伤创面感染病原菌分布及耐药性分析

目的：分析烧伤患者创面感染的病原菌分布及其耐药性，为临床合理选用抗菌药物提供依据。方法：对2009年3月至2012年12月从烧伤感染患者的创面分泌物标本中分离出的病原菌，采用法国生物梅里埃VITEK2～Compact全自动微生物分析仪及配套的鉴定及药敏鉴定卡，进行鉴定及药物敏感性试验。对病原菌的分布及耐药性进行分析。结果：分离出的446株病原菌中，革兰阴性（G-）杆菌312株，占69．96％，主要为鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌；革兰阳性（G＋）球菌133株，占29．82％，主要为金黄色葡萄球菌、肠球菌属和表皮葡萄球菌；真菌l株，占0．22％，为白色假丝酵母茵。其中耐甲氧西林金黄色葡萄球菌（MRSA）在金黄色葡萄球菌中的检出率为71．59％。结论：烧伤患者创面感染的病原菌以革兰阴性（G-）杆菌和金黄色葡萄球菌为主，且主要致病菌常为多药耐药。加强其病原茵分布及耐药性监测，对指导临床合理用药和减少多药耐药菌产生，具有重要意义。

Pathogenic Distribution and Drug Resistance of Bacteria from Wound Infections in Burn Patients

Objective： To analyze the pathogenic bacteria distribution and drug resistance from secretion of burn wounds, and instruct clinical application of antibiotics reasonably. Method： Using VTEK2-Compact automatic microbial identification and sensitivity machine to analyse the pathogenic bacteria that isolated from infectious wounds in burn patients from Mar. 2009 to Dec. 2012. Result： Totally 446 strains were isolated, among them 312 strains were Gram-negative bacteria, 113 strains were Gram-positive one, and 1 strain was fungus, and the percentage of these three groups was 69.96% ,29.82% and 0.22% ,respectively. The main strains of the Gram-negative bacteria were Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, and that of the Gram-positive bacteria were Staphylococcus aureus, Entcrocoecus and Staphylococcus epidermidis. The only strain of fungus was Candida albicans. It is worth to note that 71.59% of S. aureus iso- lates were methicillin resistant S. aureus （MRSA）. Conclusion： The major pathogenic bacteria isolated from secretion of burn wounds are Gram-negative bacteria and S. aureus. Most of the pathogenic bacteria are the Multi-drug resistant ones. Enhanced monitoring on pathogenic bacteria distribution and drug resistance analyses among burn patients would help to guide clinical rational administration of antibiotics and depression of muhidru G- resistant bacteria.