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2008年汶川地震后儿童伤口感染分离出的病原菌的微生物学研究

Microbiological study of pathogenic bacteria isolated from paediatric wound infections following the 2008 Wenchuan earthquake.

作者信息

Ran Ying-Chun, Ao Xiao-Xiao, Liu Lan, Fu Yi-Long, Tuo Hui, Xu Feng

机构信息

Intensive Care Unit, Children's Hospital, Chongqing Medical University, Chongqing, China.

出版信息

Scand J Infect Dis. 2010 May;42(5):347-50. doi: 10.3109/00365540903510682.

Abstract

On 12 May 2008, the Wenchuan earthquake struck in Sichuan, China. Within 1 month after the earthquake, 98 injured children were admitted to the Children's Hospital of Chongqing Medical University. According to clinical manifestations, 50 children were diagnosed with wound infections. Wound secretions were cultured for bacteria. Pathogen distribution and drug resistance were analyzed. A total of 99 pathogens were isolated; 16 (16%) were Gram-positive bacteria and 81 (82%) were Gram-negative bacteria. The distribution of pathogens isolated within 1 month after the earthquake was different to the distribution of pathogens in 546 general hospitalized cases in the y before the earthquake. The pathogens most frequently isolated 1 month after the earthquake were Acinetobacter baumannii (27%), Enterobacter cloacae (18%) and Pseudomonas aeruginosa (13%). The pathogens most frequently isolated in the y prior to the earthquake were Escherichia coli (27%), Staphylococcus aureus (23%) and coagulase-negative staphylococci (9%). The rate of isolated drug-resistant bacteria was higher in the earthquake cases than in the general hospitalized cases. In the cases injured in the earthquake, the rates of isolation of methicillin-resistant Staphylococcus aureus and extended-spectrum beta-lactamase-producing E. cloacae, E. coli and Klebsiella pneumoniae were higher than in the cases from before the earthquake. Multidrug-resistant and pandrug-resistant A. baumannii were isolated at a higher rate in cases after the earthquake than in those before the earthquake. These changes in the spectrum of pathogens and in the drug resistance of the pathogens isolated following an earthquake will provide the basis for emergency treatment after earthquakes.

摘要

2008年5月12日,中国四川省发生汶川地震。地震发生后1个月内,98名受伤儿童被收治于重庆医科大学附属儿童医院。根据临床表现,50名儿童被诊断为伤口感染。对伤口分泌物进行细菌培养,并分析病原菌分布及耐药情况。共分离出99株病原菌;其中革兰阳性菌16株(16%),革兰阴性菌81株(82%)。地震后1个月内分离出的病原菌分布与地震前1年546例普通住院病例的病原菌分布不同。地震后1个月内最常分离出的病原菌为鲍曼不动杆菌(27%)、阴沟肠杆菌(18%)和铜绿假单胞菌(13%)。地震前1年最常分离出的病原菌为大肠埃希菌(27%)、金黄色葡萄球菌(23%)和凝固酶阴性葡萄球菌(9%)。地震病例中分离出的耐药菌比例高于普通住院病例。在地震受伤病例中,耐甲氧西林金黄色葡萄球菌以及产超广谱β-内酰胺酶的阴沟肠杆菌、大肠埃希菌和肺炎克雷伯菌的分离率高于地震前病例。地震后病例中多重耐药和泛耐药鲍曼不动杆菌的分离率高于地震前病例。地震后病原菌谱及分离出的病原菌耐药性的这些变化将为地震后的紧急治疗提供依据。

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