1995-2011年解放军总医院第一附属医院烧伤科感染病原菌结构和耐药水平的变化

目的：了解1995年以来解放军总医院第一附属医院烧伤病区病原菌结构及主要病原菌耐药水平的变化。方法：分析1995—2011年烧伤病区标本细菌鉴定及药敏试验结果。结果：1995年构成比最高的病原菌前3位依次为大肠杆菌（ECO，21．35％）、铜绿假单胞菌（PAE，19．53％）和金黄色葡萄球菌（SAU，17．71％），2011年构成比最高的前3位变为鲍曼不动杆菌（ABA，20．32％）、SAU（19．59％）和PAE（18．29％）。PAE和ABA两种病原菌对亚胺培南的耐药率逐渐升高，至2011年分别接近70％和超过了90％。SAU对苯唑西林的耐药率从1998年开始快速升高，2003年超过70％，而后波动于60％～70％。结论：17年来我院烧伤感染病原菌的结构发生了明显变化。虽然构成比经历了大幅度的变化过程，SAU和PAE依旧保持了主要病原菌的地位；而ABA则异军突起，成为构成比最高的病原菌，且这3种病原菌的耐药水平也达到了非常高的水平。

Changes in bacterial isolates from the burn unit of First Hospital Affiliated to the Chinese PLA General Hospital from 1995 to 2011 and their resistance to antibiotics

Objective：To analyze the change in bacterial isolates from the burn unit of First Hospital Affiliated to the Chinese PLA General Hospital in recent 17 years, and their resistance to various antibiotics. Methods： To aria lyze the data of bacterial isolates from the burn unit from 1995 to 2011, and their susceptibility to various antibiotics. Results： Escherichia coli（ECO） was isolated most frequently（21.35 %）, followed by Pseudomonas aeruginosa （PAE, 19.53 % ） and Staphylococcus aureus （SAU, 17.71% ） in 1995, but most common pathogens were found to be Acinetobacter baumannii（ABA, 20. 32%）, SAU （19.59%） and PAE （18. 29%） in 2011. The resistant rate of PAE and ABA to imipenem was found to rise, reaching 70%and 90% respectively in 2011. The resistant rate of SAU to Oxacillin reached 70 % in 2003, and fluctuated around this level. Conclnsions：The obviously changes in bacterial isolates in the burn unit are observed in the past 17 years, SAU and PAE are the main bacteria and ABA becomes the most predominant pathogen. The three rnost frequently isolated pathogens show high resistance to key antibiotics. The results suggest that the control and treatment of burn infection have become more difficult.