烧伤创面和焦痂下组织菌种分布和耐药性比较

目的 观察烧伤创面和焦痂下菌种分布和耐药性及其关系,探讨其在烧伤病人选择抗生素治疗中的意义。方法 1993～2000年865例烧伤病人创面和焦痂下组织中分离获得1119株和291株细菌,回顾分析细菌学和耐药性监测情况,并分组比较。结果 烧伤创面和焦痂下组织中G-菌和G+菌的分布有显著差异,各菌种比例亦有差异(P<0.05或P<0.01)。菌种构成仍以金黄色葡萄球菌、铜绿假单胞菌和肠杆菌科细菌为主,其在创面和焦痂下组织的耐药率无显著差别(P>0.05);万古霉素、耐替米星和亚胺配南是以上优势菌的首选抗生素。结论 烧伤创面和焦痂下组织菌种分布虽各有特点,但主要菌种构成比和耐药性趋势基本一致;未作焦痂下细菌鉴定或无条件作焦痂下细菌鉴定时,烧伤创面细菌和耐药性鉴定可作为诊治烧伤病人创面感染的参考。

Comparison of the distribution of bacteria strains and their resistance to the antibiotics between burn wound and subeschar tissue

Objective To compare the distribution of bacteria strains and their resistance to antibiotics in current use on the burn wounds and subeschar tissues. Methods The bacteriological monitoring data of burn wounds and subeschar tissues in our burn center were retrospectively analyzed from 1993 to 2000. The distribution and their resistance to the antibiotics in 865 patients were compared statistically by dividing into two groups, those from wounds and those from subeschars, respectively. Results There was a significant difference in the distribution of Gram' s staining bacteria strains of between wounds group and subeschar group. But the majority of bacteria strains were staphylococcus aureus, pseudomonas and enterobacteriaceae in both groups and their resistance to antibiotics are relatively homologous. Vacomycin, netilmicin and imipenem were the first choice for most bacteria strains. Conclusion There is a difference in the distribution of bacteria strains between the burn wound and the subeschar tissue but the major bacteria components from two different sites of the wound and theirresistance to the antibiotics are relatively homologous. Therefore, the identification of bacteria and its resistance to the antibiotics on the burn wound could be reference index in the treatment of burn wound infection with negligance in the subeschar tissue.