Dou Yi, Huan Jingning, Guo Feng, Zhou Zengding, Shi Yan
Burn and Plastic Surgery Department, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, 200025 China.
J Int Med Res. 2017 Jun;45(3):1124-1137. doi: 10.1177/0300060517703573. Epub 2017 Apr 26.
Objective To assess the application of antibacterial agents, alongside pathogen prevalence and Pseudomonas aeruginosa drug resistance, with the aim of understanding the impact of inappropriate antibacterial use. Methods This retrospective study assessed bacteria from wounds, catheters, blood, faeces, urine and sputum of hospitalized patients in burn wards between 2007 and 2014. The intensity of use of antibacterial agents and resistance of P. aeruginosa to common anti-Gram-negative antibiotics were measured. Results Annual detection rates of Staphylococcus aureus were significantly decreased, whereas annual detection rates of P. aeruginosa and Klebsiella pneumoniae were significantly increased. Multidrug-resistant strains of P. aeruginosa were increased. The intensity of use of some anti-Gramnegative antibiotics positively correlated with resistance rates of P. aeruginosa to similar antimicrobials. Conclusion In burn wards, more attention should be paid to P. aeruginosa and K. pneumoniae. The use of ciprofloxacin, ceftazidime and cefoperazone/sulbactam should be limited to counter the related increase in resistance levels.
目的 评估抗菌药物的应用情况以及病原菌的流行情况和铜绿假单胞菌的耐药性，以了解不当使用抗菌药物的影响。方法 这项回顾性研究评估了2007年至2014年烧伤病房住院患者伤口、导管、血液、粪便、尿液和痰液中的细菌。测定了抗菌药物的使用强度以及铜绿假单胞菌对常见抗革兰氏阴性菌抗生素的耐药性。结果 金黄色葡萄球菌的年度检出率显著下降，而铜绿假单胞菌和肺炎克雷伯菌的年度检出率显著上升。铜绿假单胞菌的多重耐药菌株有所增加。一些抗革兰氏阴性菌抗生素的使用强度与铜绿假单胞菌对类似抗菌药物的耐药率呈正相关。结论 在烧伤病房，应更加关注铜绿假单胞菌和肺炎克雷伯菌。应限制环丙沙星、头孢他啶和头孢哌酮/舒巴坦的使用，以应对相关耐药水平的上升。
