本文選題：燒傷　切入點：途徑　出處：《廣西醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的 定期監(jiān)測廣西醫(yī)科大學第一附屬醫(yī)院燒傷病房燒傷感染患者的病原菌種類及感染途徑和細菌耐藥情況,為臨床預防和治療感染提供參考依據。方法采用回顧性調查方法,收集廣西醫(yī)科大學第一附屬醫(yī)院燒傷病房2012年1月到2014年12月間燒傷感染患者的性別、年齡、燒傷原因、燒傷面積、住院時間、病原菌種類、感染途徑和藥敏情況等。結果 燒傷感染患者共326人,分離出非重復病原菌共589株,感染途徑5種。1.檢出革蘭陰性桿菌408株占69.3%、革蘭陽性球菌137株占23.3%和真菌44株占7.5%。2.燒傷感染途徑共5種：燒傷創(chuàng)面占第一位(517株占87.8%),其次是靜脈導管(33株占5.6%),呼吸道(30株占5.1%)、尿路(6株占1%)和血液(3株占0.5%)。3.檢出率居前八位的病原菌由高至低為：鮑曼不動桿菌、銅綠假單胞菌、金黃色葡萄球菌、肺炎克雷伯菌、大腸埃希菌、陰溝腸桿菌、糞腸球菌、奇異變形桿菌。4.不同季節(jié)檢出前八位的病原菌中,各種細菌檢出率有季節(jié)性意義。5.不同燒傷原因中,鮑曼不動桿菌在火焰燒傷中檢測率高。6.燒傷面積大于等于50%組與小于50%組細菌分布有差別。7.主要革蘭陽性球菌藥敏情況：金黃色葡萄球菌對利奈唑胺、替加環(huán)素、萬古霉素的耐藥率均為0。耐甲氧西林金黃色葡萄球菌MRSA占43.3%。8.三種主要革蘭陰性桿菌藥敏情況：對鮑曼不動桿菌,左氧氟沙星總耐藥率為46.5%,對其他抗生素耐藥率在77%-94.8%。對銅綠假單胞菌,總的耐藥率不高,其中最低的3位是哌拉西林他唑巴坦27.5%。阿米卡星30.4%,亞胺培南33.3%。對肺炎克雷伯菌,亞胺培南的總耐藥率為7.7%,最高的為復方新諾明74.4%結論：通過綜合分析燒傷患者的感染途徑,病原菌和藥敏情況,加強相關監(jiān)測,做好預見性干預措施,提高燒傷感染的診療水平。1.各種感染途徑中,創(chuàng)面感染是主要的感染途徑。2.革蘭陰性桿菌的檢出率遠遠高于革蘭陽性球菌,可能與本地區(qū)的特殊氣候有關。3.各種細菌檢出率有季節(jié)性意義。4.鮑曼不動桿菌的耐藥率總體偏高,值得引起臨床的重視。5.萬古霉素仍是治療金黃色葡萄球菌感染的有效藥物。6.各種細菌多重耐藥情況日趨嚴重,對合理應用抗生素提出更高要求。
[Abstract]:The type of pathogenic bacteria and drug resistance in patients with bacterial infection and the infection of burn burn wards of the First Affiliated Hospital of Guangxi Medical University to regularly monitor and provide reference for clinical prevention and treatment. Methods Retrospective investigation, collecting the First Affiliated Hospital of Guangxi Medical University from January 2012 to December 2014 in burn ward burn infection in patients with sex, age, cause of burns. Burn area, hospitalization time, pathogens, infection and drug sensitivity. Results the infection of burn patients with a total of 326 people, isolated 589 strains of bacteria were not repeated, infection of 5.1. detected 408 strains of gram negative bacilli accounted for 69.3%, gram positive cocci accounted for 23.3% and 137 strains of fungi were 44 7.5%.2. infection were 5: burn burn wound for the first (517 strains, 87.8%), followed by venous catheter (33 strains accounted for 5.6% (30 strains), respiratory tract, urinary tract (5.1%) 6 strains accounted for 1%) and blood (3 strains 0.5%) pathogen detection rate of.3. in the top eight from high to low: Bauman Acinetobacter, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Enterococcus faecalis, Enterobacter cloacae, proteus..4. is not the same season as one of the top eight pathogenic bacteria, bacteria detection rate of seasonal.5. different burn causes, Bauman Acinetobacter detection in the high rate of.6. flame burn in burn area is greater than or equal to 50% and less than 50% group group of bacteria distribution difference of.7. mainly gram positive cocci susceptibility: Gold aureus to linezolid, tigecycline and vancomycin resistance rate was 0. MRSA in methicillin-resistant Staphylococcus aureus accounted for 43.3%.8. of three gram negative bacilli susceptibility of Bauman Acinetobacter, levofloxacin total drug resistance rate was 46.5%, on the other. Hormone resistance rate of 77%-94.8%. of Pseudomonas aeruginosa, the total resistance rate is not high, the lowest is 3 piperacillin tazobactam 27.5%. Amikacin 30.4%, Klebsiella pneumoniae imipenem 33.3%., total imipenem resistance was 7.7%, the highest for the SMZ-TMP 74.4% conclusion comprehensive analysis of infection in burn patients, pathogen and drug sensitivity, strengthen monitoring, foreseen intervention measures to improve the level of diagnosis and treatment of.1. infection of burn infection in various ways, wound infection is.2. was the main infection of gram negative bacilli far higher than the rate of gram positive cocci, with special local climate the.3. detection rate of bacterial resistance to seasonal.4. Bauman Acinetobacter rate is high, is the treatment of staphylococcal infections caused by effective clinical importance to vancomycin is still.5. The multidrug resistance of various bacteria in the drug.6. is becoming more and more serious, and it is more demanding for the rational use of antibiotics.

【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R644

【參考文獻】

相關期刊論文 前10條

1 李樂;傅躍先;;近8年中國燒傷創(chuàng)面細菌譜變遷及藥敏變化[J];重慶醫(yī)學;2010年20期

2 侯舒毅;宋秀宇;;整合子系統(tǒng)與銅綠假單胞菌多藥耐藥關系的研究進展[J];國際檢驗醫(yī)學雜志;2012年06期

3 習慧明;徐英春;朱德妹;汪復;倪語星;孫景勇;孫自鏞;簡翠;胡云建;艾效曼;張泓;李萬華;賈蓓;黃文祥;王傳清;王愛敏;魏蓮花;吳玲;卓超;蘇丹虹;張朝霞;季萍;徐元宏;熊自忠;沈繼錄;單斌;杜艷;俞云松;楊青;;2010年中國CHINET鮑曼不動桿菌耐藥性監(jiān)測[J];中國感染與化療雜志;2012年02期

4 劉曉云;鈕博;王敏;邊廣珠;李峰;;銅綠假單胞菌超廣譜β-內酰胺酶和頭孢菌素酶表型檢出與耐藥分析[J];實用醫(yī)技雜志;2010年06期

5 李蘇利;華川;;銅綠假單胞菌多重耐藥及泛耐藥研究進展[J];山西醫(yī)藥雜志(下半月刊);2013年08期

6 王洪斌,李素芝,何代平,肖成志,黃應紅,王雪莎;高原地區(qū)燒傷創(chuàng)面細菌學調查分析[J];中華燒傷雜志;2004年02期

7 江濤,羅永艾;醫(yī)院獲得性鮑曼不動桿菌肺炎的臨床調查[J];中華醫(yī)院感染學雜志;2002年04期

8 高玲;王霞;王艷霞;張麗珍;胡雪飛;李俊明;;醫(yī)院燒傷感染患者的病原菌分布及耐藥性分析[J];中華醫(yī)院感染學雜志;2013年04期

9 孫青菊;梁冰;;銅綠假單胞菌對β-內酰胺類抗菌藥物耐藥及傳播機制的研究進展[J];微生物與感染;2013年02期

10 魯海強;劉達恩;陳小婷;吳澤兵;李順堂;唐屈;;2007-2011年燒傷患者病原菌分布及耐藥性分析[J];中華醫(yī)院感染學雜志;2013年22期

，

本文編號：1629336