烧伤创面肠杆菌科细菌耐药性的临床研究

目的探讨烧伤创面肠杆菌科细菌耐药性的变化，提出目前烧伤病房肠杆菌科细菌的耐药趋势。方法2001—2004年7月烧伤病人创面分离获得细菌菌株1077株中肠杆菌科细菌的检出率。并分析肠杆菌科细菌对阿米卡星、环丙沙星、头孢派酮／舒巴坦、头孢噻肟、头孢他啶、头孢吡肟、亚胺培南的耐药性的变化。结果1077株烧伤创面细菌中肠杆菌科细菌为223株，占总细菌检出率的20．7％，肠杆菌科细菌对阿米卡星、环丙沙星的耐药率在38．14％和48．39％，对头孢菌素类抗生素头孢噻肟、头孢他啶、头孢吡肟的耐药率分别为31．82％、21．52％和28．38％，对头孢哌酮-舒巴坦的耐药率为26．58％，亚胺培南的耐药率为0％。结论与以前的研究相比，烧伤创面肠杆菌科细菌对头孢菌素类抗生素耐药率呈下降趋势，其变化与抗生素的选择性压力有关。亚胺培南仍为烧伤创面肠杆菌科细菌感染的首选抗生素。

The clinical research for antibiotics resistance of Enterobacteriaceae from burn wounds

Objective To study the antibiotics resistance trend of Enterobacteriaceae in bum center in recent years, we investigated the changes of drug resistance of Enterobacteriaceae of bum wounds. Methods Enterobacteriaceae in 1077 bacteria strains from bum wounds from july 2001 to July 2004 were collected and the changes of the drug resistance of Enterobacteriaceae analysed to amikacin, ciprofloxacin, cefoperazone/sulbactam, cefotaxime, ceftazidime, cefepime and imipenem. Results Enterobacteriaceae accounted for 20.7 percent of 1077 bacteria strains with 223 strains. Respectively the drug resistant ratio of enteric bacilli to amikacin, ciprofloxacin, cefotaxime , ceftazidime, cefepime, cefoperazone/sulbactam and imipenem is 38.14%, 48.39%, 31.82%, 21. 52%, 28.38 %, 26.58 % and 0%. Conclusion Compared with previous researches , the drug resistance of enteric bacilli to Cephalisporins is descending and might relate with antibiotics selection pressure. Imipenem would still be the principal choice to enteric bacilli of bum wounds.