448例儿童烧伤患者病原菌分布调查及抗菌药物敏感性分析
Investigation on the distribution of pathogenic bacteria and analysis of antimicrobial susceptibility in 448 children with burn
熊婉娟 1郭婷婷 1邹吉利 1武华军 1朱丽 1杨秋香 1谢玲 1王菁菁 1吴金虎 1栾夏刚 2邹瑞3
作者信息
- 1. 武汉市第三医院药学部 湖北 武汉 430061;武汉市重症感染个体化诊疗临床医学研究中心 湖北 武汉 430061
- 2. 武汉市第三医院烧伤科 湖北 武汉 430061
- 3. 湖北省药品监督检验研究院 湖北 武汉 430075
- 折叠
摘要
目的:分析小儿烧伤后创面分泌物感染病原菌分布及对抗菌药物敏感性.方法:收集 2018年 1月—2021年12月武汉市第三医院烧伤儿科病房内符合入选标准的小儿住院烧伤患者共448例.对患儿创面分泌物进行细菌培养及药物敏感试验,对菌种分布特点及抗菌药物敏感性进行统计分析.结果:共培养阳性次数514次,检出532株病原菌.其中革兰阳性菌以金黄色葡萄球菌为主,其次为溶血葡萄球菌及表皮葡萄球菌,分别为251株(47.18%),29株(5.45%),25株(4.70%).革兰阴性菌以铜绿假单胞菌为主,其次为鲍曼不动杆菌,分别为84株(15.79%),31 株(5.83%).多重耐药菌株占比最高的是鲍曼不动杆菌(93.55%),其次为表皮葡萄球菌(84.00%)、溶血葡萄球菌(82.76%)、铜绿假单胞菌(78.57%).结论:创面感染是延迟小儿烧伤愈合的重要因素,我院小儿烧伤创面感染致病菌革兰阳性菌高于革兰阴性菌和真菌,主要致病菌为金黄色葡萄球菌,其次为铜绿假单胞菌及鲍曼不动杆菌.而革兰阴性菌耐药率高于革兰阳性菌,尤其是鲍曼不动杆菌,仅对多黏菌素表现出高敏感性.在小儿烧伤患者创面感染患者治疗中要根据药物敏感试验结果,合理选择抗菌药物,降低细菌耐药性.
Abstract
Objective:To analyze the distribution of pathogens and their sensitivity to antibiotics in pediatric post-burn wound secretions.Methods:A total of 448 hospitalized pediatric burn patients who met the inclusion criteria in the burn pediatric ward of Wuhan Third Hospital from January 2018 to December 2021 were collected.Bacterial culture and drug sensitivity tests were carried out on the wound secre-tion of children,and the distribution characteristics of bacteria and antimicrobial sensitivity were statis-tically analyzed.Results:The positive times of co-culture were 514,and 532 strains of pathogens were detected.The Gram-positive bacteria were mainly Staphylococcus aureus,followed by hemolyt-ic Staphylococcus and Staphylococcus epidermidis,with 251 strains(47.18%),29 strains(5.45%),and 25 strains(4.70%),respectively.Pseudomonas aeruginosa was the main Gram-negative bacte-ria,followed by Acinetobacter baumannii,with 84 strains(15.79%)and 31 strains(5.83%)respec-tively.In this study,Acinetobacter baumannii(93.55%)accounted for the highest proportion of multidrug-resistant strains,followed by Staphylococcus epidermidis(84.00%),Staphylococcus hae-molyticus(82.76%),and Pseudomonas aeruginosa(78.57%).Conclusion:Wound infection is an im-portant factor in delaying burn healing in children.The most common pathogens of burn wound infec-tion in children in the investigation are Gram-negative bacteria,followed by Gram-negative bacteria and fungi.The main pathogenic bacteria are Staphylococcus aureus,followed by Pseudomonas aerugi-nosa and Acinetobacter baumannii.The drug resistance rate of Gram-negative bacteria was higher than that of Gram-positive bacteria,especially Acinetobacter baumannii,which only showed high sen-sitivity to polymyxin.In the treatment of pediatric burn patients with wound infection,antibiotics should be reasonably selected according to the results of drug sensitivity tests to reduce bacterial drug resistance.
关键词
烧伤/儿童/感染/病原菌/敏感性Key words
Burns/Child/Infection/Pathogen/Susceptibility引用本文复制引用
基金项目
湖北省中央引导地方科技发展专项(2020ZYYD026)
武汉市卫生健康委员会医学科研项目(WX18Z19)
出版年
2024
NETL
NSTL
万方数据