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[摘要]
目的 对百色市人民医院烧伤病房患者感染致病菌的分布特点及耐药情况进行分析,为临床合理选用抗菌药提供依据。方法 回顾性调查分析2008—2012年百色市人民医院烧伤住院患者分离病原菌的菌群分布及及耐药情况。结果 共检出506株病原菌,其中革兰阴性杆菌325株,占64.2%,主要为铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌和阴沟肠杆菌;革兰阳性球菌161株,占31.8%,主要为金黄色葡萄球和肠球菌;真菌20株占4.0%,主要为白色假丝酵母菌。金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为88.6%;超广谱β-内酰胺酶(ESBLs)在肺炎克雷伯菌和大肠埃希菌中的检出率分别为64.0%、43.1%。药物敏感实验结果显示,各检出菌具有多药耐药性,革兰阳性菌对万古霉素敏感,革兰阴性菌对亚胺培南敏感,两者均对头孢菌素类耐药率较高。结论 百色市人民医院烧伤病房患者感染的病原菌以革兰阴性杆菌为主,主要致病菌对常用抗菌药物耐药情况严重,应加强其病原菌分布及耐药性动态监测,以指导临床进行合理规范的抗感染治疗。
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[Abstract]
Objective To analyze the pathogenic bacteria distribution and drug resistance in burn wards of People’s Hospital of Baise City, which could provide the certain reference for using the drugs reasonably. Methods The clinical data of pathogenic bacteria distribution and drug resistance from 2008 to 2012 were reviewed retrospectively. Results Totally 506 strains of bacteria were isolated, including 325 (64.2%) strains of Gram-negative bacilli among which Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, and Enterobacter cloacae were dominant; 161 (31.8%) stains of Gram-positive bacilli among which Staphylococcus aureus and Enterococcus were dominant; 20 (4.0%) stains of fungi among which Candida albicans was dominant. The detection rate of meticillin-resistanct Staphylococcus aureus (MRSA) accounted for 88.6% in Staphylococcus aureus stains; the detection rate of the extended spectrum β-lactamases (ESBLs) from the Klebsiella pneumoniae and the Escherichia coli was 64.0% and 43.1%, respectively. Drug susceptibility testing showed that various detectable bacteria possessed multi-drug resistance, Gram-positive bacilli were sensitive to Vancomycin, Gram-negative bacilli were sensitive to imipenem, and the pathogenic bacteria were resistant to the first generation of cephalosporins. Conclusion The bacterial infection in the burn wards in People’s Hospital of Baise City is mainly Gram-negative bacilli, and with serious drug resistance to antibiotics which are commonly used. Doctors should strengthen the detecting of pathogens and monitoring of bacterial drug resistance, so as to guide the clinical anti-infectious treatment reasonably and normatively.
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