我院烧伤患者创面细菌耐药性分析及抗菌药物的选择

目的：了解我院烧伤科患者创面细菌耐药性情况，为，临床合理选用抗菌药物提供依据。方法：2006。2007年我院收治的108例烧伤患者创面分泌物及焦痂的细菌培养及药敏试验结果进行回顾性分析、总结。结果：在分离的169株细菌中，革兰阴性杆菌为123株，占72．78％，革兰阳性球菌为46株，占27．2％。主要菌种有：不动杆菌48株（28．4％），金葡菌38株（22．48％），大肠埃希菌17株（10．6％），铜绿假单胞菌16株（9．47％），肺炎克雷伯菌14株（8．28％），阴沟肠杆菌12株（7．1％）等。结论：我院烧伤科细菌耐药性的情况比较严重，与病房条件和抗菌药物的不合理使用存在一定的关系。抗菌药物的选用应参照烧伤患者近期的细菌生态学调查和细菌耐药性监测结果和患者的临床表现，所选药物尽量覆盖所有的致病菌，重视细菌培养及药敏试验，并依据结果调整用药。

Bacterial Resistance in Burn Wounds in Patients of Our Hospital and Empirical Choice of Antibacterial Drugs

OBJECTIVE： To probe into the bacterial drug resistance in burn surgery patients so as to provide reference for rational use of antibiotics. METHODS： The results of bacterial culture and susceptibility test of wound secretions and Eschar taken from 108 patients admitted from January 2006 to December 2007 were analyzed and summarized retrospectively. RESULTS： Of the total 169 bacterial strains separated, 123 （72.78%） were gram negative bacilli and 46 （27.2%） gram positive coccus. The main species were as follows： 48 （28.4 % ） were Acinetobacter, 38 （22.48 % ） staphylococcus aureus, 17 （10.6%） Escherichia coli, 16 （9.47%） Pseudomonas aeruginosa, 14 （8.28%） Klebsiella pneumonia and 12 （7.1% ） Enterobacter cloacae. CONCLUSION： The bacterial drug resistance was serious in burn unit of our hospital, which to some degree was associated with poor ward conditions and the irrational use of antibiotics. Empirical selection of antibiotics in burn patients should be based on recent bacterial ecology and bacterial resistance test results and patients＇ clinical manifestation. It is advisable to selected drugs which are applicable for all pathogens and attach great importance to the bacterial culture and drug susceptibility test and chose medicines according to the results.