【摘要】：目的觀察檢測(cè)到多重耐藥細(xì)菌的重度燒傷患者呼吸道與創(chuàng)面致病菌培養(yǎng)情況,并分析其藥敏特征。方法重度燒傷患者13例,收集患者呼吸道與創(chuàng)面送檢標(biāo)本分離出的致病菌株共356株。收集13例患者的356株分離菌株分布情況及藥敏試驗(yàn)結(jié)果并分析。結(jié)果分離的致病菌356株中,革蘭陽(yáng)性菌5株(1.4%),革蘭陰性菌351株(98.6%)。革蘭陰性菌中,最常見(jiàn)的致病菌是鮑曼不動(dòng)桿菌、銅綠假單胞菌、陰溝腸桿菌、肺炎克雷伯菌和黏質(zhì)沙雷菌,近80%的菌株為多重耐藥或泛耐藥菌株,對(duì)頭孢菌素、碳青霉烯類和喹諾酮類幾乎全耐藥,僅部分菌株對(duì)復(fù)方磺胺、慶大霉素與丁胺卡那敏感�；颊吆粑琅c創(chuàng)傷面分離菌中存在耐碳青霉烯類肺炎克雷伯菌、耐碳青霉類陰溝腸桿菌和泛耐藥鮑曼不動(dòng)桿菌等多種多重耐藥或泛耐藥細(xì)菌交替感染;一個(gè)時(shí)間段內(nèi)某個(gè)多重耐藥菌株或泛耐藥菌株可在不同患者間傳播,并導(dǎo)致燒傷患者病情惡化甚至死亡。結(jié)論重度燒傷患者呼吸道與創(chuàng)面分離的致病菌絕大多數(shù)為革蘭陰性菌,其中最常見(jiàn)的是鮑曼不動(dòng)桿菌、銅綠假單胞菌、陰溝腸桿菌、肺炎克雷伯菌和黏質(zhì)沙雷菌,多數(shù)為多重耐藥或泛耐藥菌株,且存在多種多重耐藥或泛耐藥細(xì)菌交替感染、傳播的現(xiàn)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.
【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院臨床檢測(cè)中心;
【基金】：江蘇省衛(wèi)生廳醫(yī)學(xué)科研項(xiàng)目(Q201401) 江蘇省研究生培養(yǎng)創(chuàng)新工程項(xiàng)目(KYLX-1261) 蘇州市科教興衛(wèi)青年課題項(xiàng)目(kjxw2014008)
【分類號(hào)】：R644;R446.5

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