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目的:分析青海烧伤患者创面病原菌,拟为后续合理预防创面感染提供客观依据。方法:选择2014年1月—2015年12月青海大学附属医院烧伤整形科单中心烧伤病区收治的369例烧伤住院患者创面分泌物进行细菌培养及菌种鉴定。结果:细菌培养369例烧伤患者中266例发生创面感染,感染率72.09%;检出病原菌329株,其中革兰阳性菌134株,占40.73%;革兰阴性菌186株,占56.53%;真菌9株,占2.73%;与烧伤面积<10%的患者相比,烧伤面积≥10%的患者创面感染率明显增高,差异有统计学意义(P<0.05)。金黄色葡萄球菌和表皮葡萄球菌只有万古霉素有较高的抗菌活性。铜绿假单胞杆菌对临床常用的抗生素呈现出较高的耐药率,耐药率在49.3%以上。而鲍曼不动杆菌同样也对临床常用的抗生素呈现出高度耐药率,耐药率在以上74.3%。结论:烧伤后创面感染发生率仍较高,创面感染中以革兰阳性菌及革兰阴性菌最为常见,后期需要行药敏试验有针对性的用药。
OBJECTIVE: To analyze the pathogens of wounds in patients with burn wounds in Qinghai Province and provide an objective basis for the follow-up reasonable prevention of wound infections. Methods: From January 2014 to December 2015, 369 cases of burn inpatients with wounds admitted to Department of Burn and Plastic Surgery, Qinghai University Affiliated Hospital, Center for Burn and Wound were selected for bacterial culture and strain identification. Results: Among the 369 burned patients, 266 cases were infected with wounds, the infection rate was 72.09%; 329 pathogens were detected, of which 134 were Gram-positive bacteria, accounting for 40.73%; 186 were Gram-negative bacteria accounting for 56.53% 9 strains, accounting for 2.73%. Compared with those with burn area <10%, the wound infection rate in patients with burn area≥10% was significantly higher (P <0.05). Staphylococcus aureus and Staphylococcus epidermidis only vancomycin has a higher antibacterial activity. Pseudomonas aeruginosa clinical antibiotics commonly showed a higher rate of resistance, resistance rate of 49.3% or more. Acinetobacter baumannii also showed a high rate of resistance to antibiotics commonly used in clinical practice, with resistance rates above 74.3%. Conclusion: The incidence of wound infection after burn wound is still high. Gram-positive bacteria and Gram-negative bacteria are the most common infections in wound infection. Drug-sensitive tests are needed in the later stage.