大面积烧伤患者病原菌分布特点与耐药性分析

发布时间：2019-01-10 09:12

【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 investigate the distribution of pathogens and drug resistance in patients with large area burn and to provide reference for clinical treatment. Methods 117 patients with extensive burn were selected from January 2013 to July 2015. The infection rate of the patients was analyzed and the strains were isolated and identified by routine method. The results were analyzed by WHONET5.6 software. Results among 117 patients with extensive burn, 32 cases were infected and the infection rate was 27.35%. 215 strains of pathogenic bacteria were isolated from the infected patients, 41 strains of Gram-positive bacteria accounted for 19.07%, 165 strains of Gram-negative bacteria accounted for 76.74%. Among them, Acinetobacter baumannii and Klebsiella pneumoniae were the most detected, accounting for 42.33% and 15.34% respectively. Acinetobacter baumannii had high resistance to kanamycin, aztreonam and gatifloxacin, and Pseudomonas aeruginosa had higher resistance to cefotaxime, reaching 100.00g. Conclusion Acinetobacter baumannii and Klebsiella pneumoniae are the main isolates, and Pseudomonas aeruginosa is especially resistant to multiple drugs. Acinetobacter baumannii is the main cause of death from burn infection. Treatment with VSD can significantly reduce wound infection and prevent and control systemic infection.
【作者单位】：苏州市立医院北区烧伤整形科;
【基金】：江苏省苏州市临床重点病种诊疗技术专项基金资助项目(LCZX201510)
【分类号】：R644

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