2003-2005年积水潭医院烧伤感染常见细菌及耐药性分析

目的 了解笔者单位近期的烧伤感染细菌分布及耐药情况。方法 收集2003年1月-2005年12月从笔者单位492例烧伤住院患者创面分泌物、静脉导管、血液、尿液、粪等标本分离而得的菌株，对其菌种分布特点及耐药性进行分析。结果 送检标本中革兰阴性菌多于革兰阳性菌。革兰阳性菌292株，分离率最高者为金黄色葡萄球菌（16．7％），其中甲氧西林耐药金黄色葡萄球菌在金黄色葡萄球菌中占82．5％；革兰阴性菌372株，分离率较高的分别为铜绿假单胞菌（12．5％）、大肠埃希菌（11．1％）。3年中大肠埃希菌和肺炎克雷伯菌对超广谱β内酰胺酶的耐药率分别为60．8％和42．9％。结论 笔者单位烧伤病区细菌耐药问题严重，仍需不断监测病区菌种变化及药物敏感情况，以有效地控制细菌感染和耐药菌株的播散。

Analysis of predominant bacteria of burn infection and their resistance to antibiotics in recent years

OBJECTIVE: To analyze the strains of bacteria in burn infection and their resistance to antibiotics in our burn unit in the recent years. METHODS: Bacteria were isolated from specimens from the wounds, venous lines, blood, urine and feces of the hospitalized burn patients from January 2003 to December 2005 to analyze the vicissitude of bacteria and their drug resistance. RESULTS: The number of Gram-negative bacteria (372 strains) was larger than Gram-positive ones (292 strains). Staphylococcus aureus (accounting for 16.7%) was predominant among Gram-positive bacteria, among which methicillin resistant staphylococcus aureus (MRSA) accounted for 82.5%. Among the Gram-negative bacteria, Pseudomonas aeruginosa accounted for 12.5%, and Escherichia coli accounted for 11.1%. The drug resistant ESPL-producing strains of Escherichia coli and Klebsiella pneumoniae accounted for 60.8% and 42.9%, respectively. CONCLUSION: Drug resistance to antibiotics is a serious problem in a burn unit, calling for monitoring the vicissitude of bacteria strains and antibiotics sensitivity in order to control bacterial infection and dissemination.