【摘要】 目的调查分析烧伤患者创面泛耐药菌的流行特点及危险因素,为临床提供参考。方法回顾性分析天津市第一中心医院2013年1月~2015年12月收治的烧伤患者的临床资料,调查创面泛耐药病原菌的分布特点,探讨其感染的危险因素。结果共分离出132株泛耐药菌株,分别为:鲍曼不动杆菌79株、大肠埃希菌24株、铜绿假单胞菌16株、阴沟肠杆菌7株、肺炎克雷伯菌5株、嗜麦芽糖窄食单胞菌1株。泛耐药的鲍曼不动杆菌、大肠埃希菌和铜绿假单胞菌耐药性较严重,对头孢类抗生素耐药性几乎达100%,对头孢哌酮/舒巴坦较敏感。烧伤患者泛耐药菌感染与烧伤深度、烧伤面积、存在早期休克、合并吸入性损伤、低蛋白血症、抗生素使用时间、创面治疗时间及合并糖尿病病史有关,与年龄无明显相关性。结论烧伤患者应积极及时抗休克及复苏治疗,纠正低蛋白血症,待患者情况稳定后尽早进行切痂植皮手术处理创面,及时进行病原细菌学培养,根据药敏检测结果指导临床及时调整、合理应用抗菌药物,防止耐药菌株的产生,减少泛耐药菌株的出现。更多还原

【Abstract】 Objective To investigate the epidemic characteristics and risk factors of Pan drug-resistant bacteria in burn wounds, and to provide reference for clinical treatment. Methods Retrospectively analysed the clinical data of the patients treated in Tianjin First Central Hospital from Jan 2013 to Dec 2015. The distribution characteristics of Pan drug-resistant bacteria were investigated, and the risk factors of infection were discussed. Results 132 Pan drug-resistant bacteria strains were isolated, as follows: Acinetobacter baumannii 79 strains, Escherichia coli 24 strains, Pseudomonas aeruginosa 16 strains, 7strains of Enterobacter cloacae, Klebsiella pneumoniae 5 strains, addicted to maltose narrow food single cell bacterial 1 strain.Acinetobacter bacillus, Escherichia coli and Pseudomonas aeruginosa resistance were very serious, the resistance rate to cephalosporins almost was 100% and was sensitive to Cefoperazone/Sulbactam. Pan drug-resistant bacteria infection in burn patients was relative to burn depth, burn area, early shock, combined with inhalation injury, low protein hyperlipidemia, antibiotic use time, wound healing time and with diabetes and had no correlation with age. Conclusion Burn patients should be actively timely treated with anti-shock, resuscitation treatment, correction of hypoproteinemia, carried out escharectomy and skin grafting operation and bacteriology culture in time, according to the drug sensitivity test results to guide clinical timely adjustment and reasonable application of anti bacteria drugs, and prevent the emergence of resistant strains, reduce the emergence of Pan drug-resistant bacteria.更多还原