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目的:分析2014-2015年湖南省浏阳市人民医院烧伤科细菌流行变迁及耐药的相关因素,从而指导临床合理用药。方法:对2014年1月—2015年12月于湖南省浏阳市人民医院住院治疗的烧伤患者创面培养病原菌(943株)以及药敏试验结果进行分析比较。结果:2014年铜绿假单胞菌为绝对优势菌,2015年优势菌群不明显,但鲍曼不动杆菌所占构成比增加。鲍曼不动杆菌对碳青酶烯类耐药率并没有随着药物用量下降而下降;铜绿假单胞菌随着碳青酶烯类抗生素使用量的下降,耐药率在下降;头孢哌酮/舒巴坦、碳青酶烯类抗生素对阴沟肠杆菌依然敏感,头孢类、半合成青霉素、喹诺酮耐药率在上升;头孢哌酮/舒巴坦、碳青酶烯类抗生素对肺炎克雷伯菌依然敏感,头孢类变化不大,喹诺酮耐药率在下降;头孢哌酮/舒巴坦、碳青酶烯类抗生素对大肠埃希菌依然敏感。结论:2014年耐药菌以铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌布为主,2015年耐药菌以鲍曼不动杆菌、肺炎克雷伯杆菌,金黄色葡萄球菌等菌分布为主。鲍曼不动杆菌、阴沟肠杆菌、肺炎克雷伯菌对阿米卡星耐药率有差异,铜绿假单胞菌对大部分抗生素耐药率有差异,大肠埃希菌对大部分抗生素耐药无明显差异。2015年较2014年治愈好转率高。
OBJECTIVE: To analyze the epidemiological changes of bacteria and the drug resistance related factors in burn department of Liuyang People’s Hospital of Hunan Province from 2014 to 2015 so as to guide clinical rational drug use. Methods: From January 2014 to December 2015, pathogenic bacteria (943 strains) and susceptibility test results of burn wound wounds hospitalized in Liuyang People’s Hospital of Hunan Province were analyzed. Results: Pseudomonas aeruginosa was the dominant predominant bacteria in 2014, and the dominant bacteria in 2015 was not obvious, but the composition ratio of Acinetobacter baumannii increased. Acinetobacter baumannii carbapenem resistance rates did not decline with the decline in the amount of drugs; Pseudomonas aeruginosa with the use of carbapenem antibiotics decreased resistance rate decreased; cefoperazone Ketones / sulbactam, carbapenem antibiotics are still sensitive to Enterobacter cloacae, cephalosporins, semisynthetic penicillin, quinolone resistance rates are rising; cefoperazone / sulbactam, carbapenem antibiotics on lung inflammation grams Klebsiella was still sensitive, little change in cephalosporins, quinolone resistance rate is declining; cefoperazone / sulbactam, carbapenem antibiotics are still sensitive to Escherichia coli. Conclusion: In 2014, the resistant strains were mainly Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Klebsiella pneumoniae. In 2015, the resistant strains were Acinetobacter baumannii, Klebsiella pneumoniae Bacillus, Staphylococcus aureus bacteria distribution mainly. Acinetobacter baumannii, Enterobacter cloacae, Klebsiella pneumoniae amikacin resistance rates are different, Pseudomonas aeruginosa most of the antibiotic resistance rates are different, Escherichia coli most of the antibiotic resistance No significant difference in medicine. In 2015, the cure rate was higher than that in 2014.