[Monitoring of bacteria resistance in burn patients].

OBJECTIVE

To monitor the bacteria resistance in burn patients.

METHODS

Disk susceptibility tests were performed and interpreted according to the NCCLS criteria. Four kinds of the third generation cephalosporins extended-spectrum beta-lactamase produced by multi-resistant of P. aeruginosa and K. Pneumoniae strains were detected after 20 microgram of sulbactam was added respectively, in contrast to no sulbactam.

RESULTS

227 strains were isolated from burn patients. 195 strains (86%) were gram-negative bacteria. Disk susceptibility showed various bacteria had high antibiotic resistance and multi-resistant rate. S. aureus was only susceptible to vancomycin, its resistant rate to imipenem was 19%. P. aeruginosa was only susceptible to polymyxin-B, its resistant rate to ceftazidime was 20%. However, after stop using ceftazidime two years, the susceptibility to gram-negative bacteria recovered. The resistant rate of ceftazidime to P. aeruginosa, E. coli, K. pneumoniae were decreased respectively. The resistance to quinolones was increased. The resistant rate of ciprofloxacin to P. aeruginosa, K. pneumoniae was increased respectively. After 20 microgram sulbactam added to cephalosporins drug disks, the primary susceptibility of ceftazidime to P. aeruginosa and K. pneumoniae recovered, and the antibiotic was better than the other cephalosporins.

CONCLUSIONS

It is important to monitor the bacteriology in burn patients at all time, and understand the changing pattern of bacterial flora, antibiotic susceptibility and bacterial strains spreading in burn ward. Extended-spectrum beta-lactamases is the cause of resistance. After sulbactam added to the third generation of cephalosporins, the beta-lactamases were inhibited, and the susceptibility of antibiotics to bacteria were increased and ceftazidime was prior to others.