某院烧伤患者感染病原菌分布及耐药性调查

 目的 研究烧伤患者感染病原菌分布特点及耐药性情况，为临床抗感染治疗及医院感染的监测和控制提供科学依据。方法 收集某院烧伤病区1165例烧伤患者的创面分泌物、静脉导管、血液、脓汁、痰液等标本分离出的菌株，回顾性分析所感染病原菌的分布特点及耐药性情况。结果 共检出病原菌962株，其中革兰阴性杆菌518株，占 53.9%，革兰阳性球菌382株，占39.7%，真菌62 株，占6.4%;2009年病原菌检出率由高至低前4位是:金黄色葡萄球菌、铜绿假单胞菌、不动杆菌属、阴沟杆菌;2010-2012年病原菌检出率由高至低前4位是:铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、阴沟杆菌;可见某院烧伤病区感染病原菌结构发生了变化，其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率逐年上升，未发现对万古霉素耐药菌株。铜绿假单胞菌的耐药问题非常突出，呈现出多重耐药性。结论 病区感染病原菌以革兰阴性菌为主，优势菌是铜绿假单胞菌和金黄色葡萄球菌。病原菌耐药问题非常严重，警示应不断监测该病区菌种变化及耐药情况，以便有效控制医院耐药菌株的增加。

Investigation and analysis of the distribution and drug resistance of pathogenic bacteria infection in burn patients

Objective To study the pathogenic bacteria distribution and drug resistance in burn patients with infection , hospitalized from January 2009 to December 2012, and provide scientific basis for monitoring and controlling clinical anti-infection treatment and hospital infection. Methods For separating bacteria wound secretion, venous catheter, blood, pus, and sputum samples were collected from 1165 burn patients in the burn ward. The distribution characteristics and drug resistance of pathogenic bacteria were analyzed. Results 962 pathogenic strains were detected, including 518 strains of gram negative bacilli, accounting for 53.9%, 382 strains of gram positive cocci, accounting for 39.7%, 62 strains of fungi, accounting for 6.4%.In 2009,the top four pathogen detection rates from high to low, were: Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter sp, Enterobacter cloacae and from 2010 to 2012,the pathogen detection rates from high to low were: four Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Enterobacter cloacae. Visible in burn wards of this hospital infection pathogens structure changes, including methicillin-resistant Staphylococcus aureus (MRSA) detection rate increased year by year, no resistance to vancomycin. Drug resistance of Pseudomonas aeruginosa was very prominent, showing multiple antibiotic resistance. Conclusions For burn ward infection pathogen Gram-negative bacteria infection, the dominant bacteria are Pseudomonas aeruginosa, followed by Staphylococcus aureus. Drug resistance of pathogens in a very serious problem, we should constantly monitor the strain variations of warning and resistance in the ward, and control resistant strains of nosocomial infection.