烧伤患者感染病原菌及耐药性分析

目的：了解烧伤患者感染病原菌和细菌耐药性变迁。方法：分别时：1991年7月～1996年6月和1996年7月～2001年6月两个时期烧伤病人的血及创面培养的细菌检出情况及药物敏感性进行调查。结果：革兰阴性菌是主要的烧伤感染菌，铜绿假单胞菌居第一位，但近五年所占百分比有所下降；革兰阳性菌中金黄色葡萄球菌居第一位，后五年较前五年有所上升，其中耐甲氧西林金黄色葡萄球菌检出率有较大程度上升；阴沟肠杆菌(10．4％)、大肠埃希菌(8．3％)、肺炎克雷伯菌(7．3％)、真菌(4．2％)检出率有一定程度的上升；金黄色葡萄球菌，铜绿假单胞菌等的耐药菌株有明显上升趋势。结论：烧伤感染病原菌和细菌耐药性变迁与头孢他啶、亚胺培南等广谱抗生素广泛应用可能有一定关系；不间断地监测烧伤感染菌种及耐药性变化，可为本病区防治感染提供有意义的参考资料。

Infective pathogens and drug resistance in burned patients]

OBJECTIVE: To find out the changes in the infective pathogens and their drug resistance in burned patients. METHODS: The patients were divided into two groups. The first group was from July 1991 to June 1996, and the second group was from July 1996 to June 2001. The bacteria of burned body surface and blood were cultured, and the bacteria and their drug sensitivity were analyzed. RESULTS: Gram-negative bacteria were the major bacteria in burn infection, among which Pseudomonas aeruginosa ranked the top. Staphylococcus aureous ranked the first among the Gram-positive bacteria, and the isolation rate of methicillin resistant Staphylococcus aureus increased; The isolation rate of Enterobacter cloacae (10.4%), Escherichia coli (8.3%), Klebsiella pneumoniae (7.3%), and fungus (4.2%) all rose. The antibiotic resistant strains of Pseudomonas aeruginosa and Staphylococcus aureous increased. CONCLUSION: The changes in pathogens of burn infection and bacterial drug resistance are related to the wide use of broad spectrum antibiotics such as cefazidime and imepenem, suggesting that dynamic observation of changes in pathogenic strains and sensitivity of bacteria to antibiotics are useful for clinical prevention and cure of burn infection.