检测到耐药细菌的重度烧伤患者呼吸道与创面细菌培养及其药敏试验结果分析

发布时间：2019-01-12 08:55

【摘要】：目的观察检测到多重耐药细菌的重度烧伤患者呼吸道与创面致病菌培养情况,并分析其药敏特征。方法重度烧伤患者13例,收集患者呼吸道与创面送检标本分离出的致病菌株共356株。收集13例患者的356株分离菌株分布情况及药敏试验结果并分析。结果分离的致病菌356株中,革兰阳性菌5株(1.4%),革兰阴性菌351株(98.6%)。革兰阴性菌中,最常见的致病菌是鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌和黏质沙雷菌,近80%的菌株为多重耐药或泛耐药菌株,对头孢菌素、碳青霉烯类和喹诺酮类几乎全耐药,仅部分菌株对复方磺胺、庆大霉素与丁胺卡那敏感。患者呼吸道与创伤面分离菌中存在耐碳青霉烯类肺炎克雷伯菌、耐碳青霉类阴沟肠杆菌和泛耐药鲍曼不动杆菌等多种多重耐药或泛耐药细菌交替感染;一个时间段内某个多重耐药菌株或泛耐药菌株可在不同患者间传播,并导致烧伤患者病情恶化甚至死亡。结论重度烧伤患者呼吸道与创面分离的致病菌绝大多数为革兰阴性菌,其中最常见的是鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌和黏质沙雷菌,多数为多重耐药或泛耐药菌株,且存在多种多重耐药或泛耐药细菌交替感染、传播的现象。
[Abstract]:Objective to observe the bacterial culture of respiratory tract and wound in severe burn patients with multidrug resistant bacteria and to analyze its drug sensitivity. Methods there were 356 strains of pathogenic bacteria isolated from respiratory tract and wound of 13 patients with severe burn. The distribution of 356 strains isolated from 13 patients and the results of drug sensitivity test were collected and analyzed. Results of 356 strains of pathogenic bacteria, 5 were Gram-positive bacteria (1.4%) and 351 Gram-negative bacteria (98.6%). Among Gram-negative bacteria, the most common pathogens are Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and Myxogenous Shareh. Carbapenem and quinolones were almost completely resistant, and only some strains were sensitive to compound sulfamide, gentamicin and amikacin. Klebsiella pneumoniae resistant to carbapenem, Enterobacter cloacae and Acinetobacter baumannii were found in respiratory tract and trauma surfaces. A multidrug resistant strain or a pan-resistant strain can spread from patient to patient over a period of time, leading to the deterioration or even death of burn patients. Conclusion Gram-negative bacteria are the most common bacteria isolated from respiratory tract and wound in patients with severe burn, among which Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and Shareh myxomucous bacteria are the most common. Most strains are multidrug resistant or pan-resistant, and there are many multidrug resistant or pan-resistant bacteria alternately infected and transmitted.
【作者单位】：苏州大学附属第一医院临床检测中心;
【基金】：江苏省卫生厅医学科研项目(Q201401) 江苏省研究生培养创新工程项目(KYLX-1261) 苏州市科教兴卫青年课题项目(kjxw2014008)
【分类号】：R644;R446.5

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