重度烧伤患者创面病原菌分布及耐药分析

目的:了解烧伤患者感染的致病菌种类、分布及药敏结果,指导对烧伤患者合理使用抗生素。方法:收集2005年1月至2007年11月烧伤面积超过50%的27例重症患者的创面分泌物、血液,共送检标本47份。结果:47份标本中有43份检出致病菌,检出率为91.2%。检出致病菌52株,共10种,其中革兰阴性菌30株,革兰阳性菌22株。在革兰阴性菌中占第一位的是铜绿假单胞菌,在革兰阳性菌中占第一位的是金黄色葡萄球菌。10种致病菌对常用的12种抗生素均有不同程度的耐药,其中金黄色葡萄球菌对9种抗生素100%耐药,但对万古霉素100%敏感。铜绿假单胞菌对三、四代头孢菌素及美洛培南也有较高的耐药率。结论:烧伤患者感染的致病菌以铜绿假单胞菌和金黄色葡萄球菌为主。监测烧伤感染菌种及耐药的变化,可为烧伤感染提供有意义的参考。

Bacteriological investigation and analysis of drug resistance of burn patients

Objective： To explore the distribution, types and drug resistance of pathogenic bacteria of burn patients, and guide the rational use of antibiotics. Methods：Forty-seven blood and wound excreta samples were collected from 27 severe burn patients treated between Jan. 2005 and Nov. 2007. The pathogenic bacteria were cultured for detection of drug sensitivity. Results ： Pathogenic bacteria were detected in 43 samples,and the detection rate was 91.2%. The total detected bacteria belonged to 10 species and 52 strains. Among them ,22 strains were G^＋ bacteria and 30 were G^- bacteria. Pseudomonas aeruginosa was ranked the first in G^- bacteriums and Staphylococcus aureus was ranked the first in G^＋ bacteriums. Drug sensitivity test indicated that 10 species of pathogenic bacteria showed different extend drug resistance to 12 commonly used antibiotics. Staphylococcus aureus showed drug resistance to 9 antibiotics but 100% sensitivity to vancocin. Aeruginosus bacillus kept higher resistance rate to the third and fourth generation cephalosporins and meropenem. Conclusions： Pseudomonas aeruginosa and Staphylococcus aureus are the two most mainly pathogenic bacteria in the infection of burn patients. Dynamic observation of changes in pathogenic strains and sensitivty of bacteria to antibiotics are useful for clinical prevention and cure of burn infection.