Cui D J
304th Hospital, PLA, Beijing.
Zhonghua Jie He He Hu Xi Za Zhi. 1990 Apr;13(2):95-8, 127.
The culture results of sputum (SP), blood (BL) and wound secretions (WS) of 47 cases of burns with lung infection were analyzed. Symptoms of pneumonia within 5 days after burn were observed in 90.3% of inhalation injury patients (IIG, 31 cases) whereas only in 25.0% of noninhalation injury patients (NIIG, 16 cases). The isolation rates of Gr(-) bacteria from the 3 sources of culture were markedly higher than those of Gr(+) cocci. The same bacteria, mainly Ps. aeruginosa and Staph. aureus, were identified simultaneously from the 3 sources of culture in 12 cases (25.5%). Isolates from SP correlated well with those from WS, the coincidence rates of 4 main Gr(-) bacteria were over 58%. Ps. aeruginosa was the commonest pathogen of IIG but Staph. aureus was the commonest in SP and BL of NIIG. The isolation rate of fungi of SP in NIIG was about twice that in IIG. Ps. aeruginosa and E. coli were susceptible to Amikacin and Polymixin B, Ps. aeruginosa was more susceptible to Cefoperazone, while the Gr(+) cocci were susceptible to first generation Cephalosporins.
分析了47例烧伤合并肺部感染患者痰液（SP）、血液（BL）和伤口分泌物（WS）的培养结果。吸入性损伤患者（IIG，31例）中90.3%在烧伤后5天内出现肺炎症状，而非吸入性损伤患者（NIIG，16例）中仅25.0%出现该症状。3种培养来源的革兰氏阴性（Gr(-)）菌分离率明显高于革兰氏阳性（Gr(+)）球菌。12例（25.5%）患者的3种培养来源同时鉴定出相同细菌，主要为铜绿假单胞菌和金黄色葡萄球菌。痰液分离株与伤口分泌物分离株相关性良好，4种主要革兰氏阴性菌的符合率超过58%。铜绿假单胞菌是吸入性损伤患者最常见的病原体，但金黄色葡萄球菌是非吸入性损伤患者痰液和血液中最常见的病原体。非吸入性损伤患者痰液中真菌分离率约为吸入性损伤患者的两倍。铜绿假单胞菌和大肠杆菌对阿米卡星和多粘菌素B敏感，铜绿假单胞菌对头孢哌酮更敏感，而革兰氏阳性球菌对第一代头孢菌素敏感。
