烧伤患者行暴露治疗下创面感染病原菌分布与耐药性研究

发布时间：2018-05-30 01:02

本文选题：烧伤 + 暴露治疗　；参考：《中华医院感染学杂志》2017年04期

【摘要】：目的探究烧伤患者行暴露治疗下创面感染病原菌分布与耐药性,以期为后期临床治疗提供参考。方法选取2013年10月-2016年6月医院收治102例烧伤患者为研究对象,均经暴露治疗,对患者烧伤感染创面分泌物标本进行病原菌检测,并进行药物敏感性试验和耐药性分析。结果 102例创面感染患者共分离出病原菌147株,其中革兰阴性菌98株占66.67%,主要为鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌,革兰阳性菌43株占29.25%,主要为金黄色葡萄球菌,真菌6株占4.08%;常见革兰阴性菌对氨苄西林的耐药率均90.00%,对氨苄西林/舒巴坦、头孢唑林、呋喃妥因、磺胺甲VA唑/甲氧苄啶等耐药率均50.00%,但铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦和头孢吡肟的耐药率较低;革兰阳性菌对青霉素G、红霉素、甲氧西林的耐药率均50.00%,对呋喃妥因、喹奴普汀/达福普汀、替加西林和万古霉素等耐药率均为0。结论烧伤行暴露治疗患者创面感染病原菌以革兰阴性菌为主,对常见抗菌药物的耐药性较强,临床应加强对各类病原菌的检测,合理使用抗菌药物,降低创面感染率。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria of wound infection in burn patients treated with exposure therapy, so as to provide reference for later clinical treatment. Methods 102 burn patients treated in our hospital from October 2013 to June 2016 were selected as the study subjects. After exposure treatment, pathogenic bacteria were detected and drug sensitivity test and drug resistance analysis were carried out on the specimens of burn infected wound secretion. Results 147 strains of pathogenic bacteria were isolated from 102 patients with wound infection, of which 98 strains were Gram-negative bacteria, mainly Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae. Forty-three strains of Gram-positive bacteria accounted for 29.25%, mainly Staphylococcus aureus, and 6 strains of fungi accounted for 4.08%. The resistance rates of common Gram-negative bacteria to ampicillin were 90.00.Ampicillin / sulbactam, cefazolin, furantoin were detected. The resistance rates of sulfamethazol / trimethoprim were 50.00.However, the resistance rates of Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae to piperacillin / tazobactam and cefepime were lower, and Gram-positive bacteria to penicillin G and erythromycin. The drug resistance rates of methicillins were 50.00g and those to furantoin, quinoplatin / dafopudine, tegacillin and vancomycin were all 0. 0%. Conclusion Gram-negative bacteria are the main pathogens of wound infection in burn patients treated with exposure, and the resistance to common antimicrobial agents is stronger. It is necessary to strengthen the detection of all kinds of pathogens in clinic, to use antibiotics rationally and to reduce the infection rate of wound.
【作者单位】：阜阳市人民医院烧伤整形科;阜阳市人民医院检验科;安徽医科大学第一附属医院烧伤科;
【基金】：安徽省科技攻关基金资助项目(1604a0802083)
【分类号】：R644

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