烧伤病房常见病原菌分布及耐药性分析

目的 对比分析近5年烧伤病房感染病原菌分布及耐药情况。方法 收集2010年1月至2014年11月笔者单位烧伤病房住院患者的血液、痰、粪、中段尿、创面分泌物、静脉导管、气管套管等标本分离获得的菌株,对各年度检出菌株的菌种分布特点及耐药性进行分析。结果 5年间送检标本检出细菌中,革兰阴性(G^-)菌株数远远多于革兰阳性(G⁺)菌株数(平均分离率G^-菌占83.2%,G⁺菌占16.8%),其中铜绿假单胞菌及鲍曼不动杆菌是近5年来主要病原菌。动态观察病原菌耐药性可见,耐药率大幅度上升,对常用抗菌药物严重耐药,部分检出菌株对常用抗菌药物已完全耐药。结论 烧伤科病房存在多种院内感染病原菌,且菌种不断变迁,鲍曼不动杆菌已成为仅次于铜绿假单胞菌的第二大优势菌种,且细菌耐药情况严重。

Analysis of predominant pathogens of distribution and drug resistance in burn wards

Objective Comparison and analysis in recent five years burn ward common pathogenic bacteria distribution and drug resistauce analysis.Methods Bacteria were isolated from blood, sputum, feces, midstream urine, the wounds, venous lines and tracheal tube of the hospitalized burn patients from January 2010 to November 2014 to analyze the vicissitude of bacteria and their drug resistance each year.Results The number of Grame-negative bacteria was far more than that of Gram-positive ones(the average separation rate of Grame-negative bacteria accounted for 83.2%, Gram-positive ones accounted for 16.8%), among which Pseudomonas aeruginosa and Acinetobacter baumannii were the major strains in recent five years. Through the dynamic observation of pathogen resistance, we discovered that there was severe resistance to commonly used antibiotics, and the general trend appeared to be increased. Furthermore, some detected strains had been completely resistant to commonly used antibiotics. Conclusion There are many kind of multidrug resistant pathogenic bacteria for nosocomial infection in our burn wards, and strain changes. The acinetobacter baumannii has replaced staphylococcus aureus to be the second major strains after Pseudomonas aeruginosa, and the drug resistance of bacteria is serious.