大面积烧伤患者病原菌分布特点与耐药性分析
Pathogenic bacteria distribution and drug resistanceanalysis of patients with large area burn
-
摘要: 目的 探讨大面积烧伤患者的病原菌分布以及耐药性,为临床治疗提供参考依据。方法 选取医院2013年1月-2015年7月收治117例大面积烧伤患者,分析患者感染率,对感染患者用常规方法分离鉴定菌株;采用WHONET5.6统计软件进行分析。结果 117例大面积烧伤患者中,发生感染32例,感染率27.35%, 感染患者中共分离出病原菌215株,革兰阳性菌41株占19.07%,革兰阴性菌165株占76.74%,真菌9株占4.19%,其中鲍氏不动杆菌和肺炎克雷伯菌检出最多,分别占42.33%和15.34%;鲍氏不动杆菌对卡那霉素,氨曲南,加替沙星耐药率高,铜绿假单胞菌对头孢噻肟有较高耐药率,达100.00%。结论 分离菌株中以鲍氏不动杆菌和肺炎克雷伯菌为主,铜绿假单胞菌的多药耐药性尤为突出,鲍氏不动杆菌成为烧伤感染死亡的主要致病菌,临床针对收治的大面积烧伤患者,采用VSD治疗,可促创面感染明显减轻,防控全身感染。Abstract: OBJECTIVE To study the pathogenic bacteria distribution and drug resistance of patients with large area burn,so as to provide a reference basis for clinical treatment.METHODS A total of 117 cases of patients with large area burn in the hospital from Jan.2013 to Jul.2015 were selected.The infection rate of patients was analyzed,and bacteria were isolated and identified by conventional methods.WHONET5.6statistical software was used for analysis.RESULTS Totally 32 cases of infection occurred in 117 cases of patients with large area burn,with the infection rate of 73.6%.Totally 215 strains of pathogenic bacteria were isolated,including 41 strains of gram-positive bacteria,165 strains of gram-negative bacteria,and 24 strains of fungi,accounting for 19.07%,77.52%,and 4.19%,respectively.The most were Acinetobacter baumannii and Klebsiella pneumonia,accounting for 42.33% and 15.34%.A.baumannii had high drug resistance to kanamycin,aztreonam,and gatifloxacin,and Pseudomonas aeruginosa had high drug resistance to cefotaxime,with the drug resistant rate of 100%.CONCLUSION The most isolated bacteria were A.baumannii and K.pneumonia,and K.pneumonia had high multi-drug resistance.A.baumanniiis the main pathogen of death of burn infection.Using the VSD treatment for patients with large area burn,can promote the significantly reducing of wound infection,thus prevent and control the systemic infection.
下载: