汶川地震伤患儿创面与同期烧伤患儿创面细菌培养及药敏实验对比分析
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摘要
目的:了解地震伤及同期烧伤患儿创面渗出物的细菌培养及药敏实验结果的差异,指导临床治疗。方法:对70例汶川地震开放性损伤患儿和同期93例烧伤患儿创面渗出物标本进行细菌培养鉴定及药敏试验。结果:地震伤患儿创面渗出物74例标本,细菌培养阳性44例(59.5%),阴性30例(40.5%),分离出病原菌71株,以G-菌为主,其中鲍曼不动杆菌最多(18株),阴沟肠杆菌次之(14株);烧伤患儿创面渗出物93例标本,细菌培养阳性45例(48.4%),阴性48例(51.6%),分离出病原菌47株,以G+菌为主,其中表皮葡萄球菌最多(12株),人葡萄球菌次之(6株)。结论:地震伤患儿以G-菌为主,可能与地震伤创面组织创伤重、创伤深、伤口污染重、伤后至获得初次救治间隔时间长、机体抵抗力弱等有关;烧伤患儿以G+菌为主,与烧伤创面相对损伤轻、创伤浅、污染轻等有关。药敏结果地震伤患儿创面常见菌以鲍曼不动杆菌常见,而该菌对多数抗生素不敏感,提示临床上应重视细菌培养以及药敏结果,合理使用抗生素,同时对地震伤患儿及烧伤创伤较重的患儿,还应结合手术,早日修复覆盖创面,减少创面感染的发生,以提高临床治愈率。
Objective:To understand the difference of bacterial cultures and the drug sensitivity tests between children patients of the Wenchuan earthquake and burn patients at the same period and to guide the clinical treatment.Methods: The samples of 70 children patients of the Wenchuan earthquake and 93 burn patients in the same period were collected and cultured.The results were analyzed and compared.Results: There were 74 samples of children patients in the earthquake.The positive rate of the bacterial culture was 59.5%(44 samples) and the negative rate was 40.5%(30 samples).There were 71 pathogens separated.The main pathogens were Gram negative bacilli,such as Acinetobacter baumannii(18 strains) and Enterobacter Cloacae(14 strains).There were 93 samples of the burn patients.The positive rate of the bacterial culture was 48.4%(45 samples),the negative rate was 51.6%(48 samples).There were 47 pathogens and the main pathogens were Gram positive Cocci,such as Staphylococcus epidermidis(12 strains) and Staphylococcus hominis(6 strains).Conclusions: The main pathogens were Gram negative bacilli in the children patients of the Wenchuan earthquake,probably related to the severity and the serious infections of the wounds,the weak resistance of the patients and the long interval to the first remedy.The main pathogens were Gram negative Cocci in the burn patients.The result of the drug sensitivity test showed that the main pathogens of the earthquake wounds were Acinetobacter baumannii,which was not sensitive to most antibiotics.We should pay more attention to the results of the bacterial culture and the drug sensitivity tests and use antibiotics reasonably.We should also implement surgery to repair wounds as quickly as possible to decrease the incidences of wound infections,thereby increasing recovery rates of patients.
Objective:To understand the difference of bacterial cultures and the drug sensitivity tests between children patients of the Wenchuan earthquake and burn patients at the same period and to guide the clinical treatment.Methods: The samples of 70 children patients of the Wenchuan earthquake and 93 burn patients in the same period were collected and cultured.The results were analyzed and compared.Results: There were 74 samples of children patients in the earthquake.The positive rate of the bacterial culture was 59.5%(44 samples) and the negative rate was 40.5%(30 samples).There were 71 pathogens separated.The main pathogens were Gram negative bacilli,such as Acinetobacter baumannii(18 strains) and Enterobacter Cloacae(14 strains).There were 93 samples of the burn patients.The positive rate of the bacterial culture was 48.4%(45 samples),the negative rate was 51.6%(48 samples).There were 47 pathogens and the main pathogens were Gram positive Cocci,such as Staphylococcus epidermidis(12 strains) and Staphylococcus hominis(6 strains).Conclusions: The main pathogens were Gram negative bacilli in the children patients of the Wenchuan earthquake,probably related to the severity and the serious infections of the wounds,the weak resistance of the patients and the long interval to the first remedy.The main pathogens were Gram negative Cocci in the burn patients.The result of the drug sensitivity test showed that the main pathogens of the earthquake wounds were Acinetobacter baumannii,which was not sensitive to most antibiotics.We should pay more attention to the results of the bacterial culture and the drug sensitivity tests and use antibiotics reasonably.We should also implement surgery to repair wounds as quickly as possible to decrease the incidences of wound infections,thereby increasing recovery rates of patients.
引文
[1]张秀珍.当代细菌检验与临床[M].北京:人民卫生出版社,1999:182-183.
[2]Jazani NH,Zartoshti M,Babazadeh H,et al.Antibacterial effectsof Iranian fennel essential oil on isolates of Acinetobacterbaumannii[J].Pak J Biol Sci,2009,12(9):738-741.
[3]戴春梅,郑兰香,陈辉.129株鲍曼不动杆菌所致医院感染的耐药性分析[J].实用预防医学,2006,13(1):62-63.
[4]王凌伟,陈升汶.不动杆菌微生物学耐药研究新进展[J].国外医药抗生素分册,2004,25(3):134-137.
[5]Thabet L,Messadi A,Mbarek M,et al.Surveillance of multidrugresistant bacteria in a Tunisian hospital[J].Tunis Med,2008,86(11):992-995.
[2]Jazani NH,Zartoshti M,Babazadeh H,et al.Antibacterial effectsof Iranian fennel essential oil on isolates of Acinetobacterbaumannii[J].Pak J Biol Sci,2009,12(9):738-741.
[3]戴春梅,郑兰香,陈辉.129株鲍曼不动杆菌所致医院感染的耐药性分析[J].实用预防医学,2006,13(1):62-63.
[4]王凌伟,陈升汶.不动杆菌微生物学耐药研究新进展[J].国外医药抗生素分册,2004,25(3):134-137.
[5]Thabet L,Messadi A,Mbarek M,et al.Surveillance of multidrugresistant bacteria in a Tunisian hospital[J].Tunis Med,2008,86(11):992-995.
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