Xu Yingbin, Li Tianzeng, Qi Shaohai, Shen Rui, Chen Dongmei, Ben Xiaosong, Zou Yanhong, Zou Yongtong
Department of Burns, The First Affiliated Hospital of Zhong Shan Medical University, Guangzhou 501180, Guangdong Province, P.R. China.
Zhonghua Shao Shang Za Zhi. 2002 Jun;18(3):159-62.
To investigate the bacterial epidemiology in our department in recent years, so as to provide assistance to the clinical management of burn patients.
A retrospective analysis was carried out with 345 bacterial cultures from burn wound and drug-sensitivity results in 784 burn patients during 1993 to 1999 in our department.
(1) Among all the bacteria, gram negative (G(-)) bacilli accounted for 56.8%, while gram positive (G(+)) cocci and fungi in 3.8%. (2) Among all the G(+) cocci, 65.4% were Staphylococcus aureus, in which MRSA was identified in 53.9% during 1993 - 1999 and in 64.3% during 1998 - 1999. Pseudomonus aeruginosa accounted for 37.2% of all G(-) bacilli. (3) The 3rd generation of cephalosporins shew excellent anti-bacterial capabilities, but the bacterial resistance to them increased significantly. (4) MRSA was very sensitive to both vancomycin and norvancomycin with no report of antibiotic resistance to them.
G(-) bacilli were still predominant bacteria in our burn department when compared to G(+) cocci. The 3rd generation cephalosporins are the routine antibiotics for the present. But resistant bacteria are on the increase. There are also more and more MRSAs isolated from burn wounds. For this, vancomycin and norvancomycin should be preferably used.
调查近年来我科的细菌流行病学情况,为烧伤患者的临床治疗提供帮助。
对1993年至1999年我科784例烧伤患者的345份烧伤创面细菌培养及药敏结果进行回顾性分析。
(1)所有细菌中,革兰阴性(G(-))杆菌占56.8%,革兰阳性(G(+))球菌和真菌占3.8%。(2)所有G(+)球菌中,65.4%为金黄色葡萄球菌,其中1993 - 1999年耐甲氧西林金黄色葡萄球菌(MRSA)检出率为53.9%,1998 - 1999年为64.3%。铜绿假单胞菌占所有G(-)杆菌的37.2%。(3)第三代头孢菌素显示出优异的抗菌能力,但细菌对其耐药性显著增加。(4)MRSA对万古霉素和去甲万古霉素均非常敏感,尚无对其耐药的报道。
与G(+)球菌相比,G(-)杆菌仍是我科烧伤患者的主要病原菌。第三代头孢菌素是目前的常规抗菌药物,但耐药菌在增加。烧伤创面分离出的MRSA也越来越多。为此,应优先使用万古霉素和去甲万古霉素。