| Objective:To study the distribution and drug resistance of the clinically isolated pathogens, which were from burn ward of First Affiliated Hospital of Anhui Medical University in the recent five years, and analysis changes of bacterial species and drug resistance,so as to provide a reference for clinical anti-infective therapy.Methods:Bacteria were isolated from blood, sputum,feces, midstream urine,the wounds, venous lines and tracheal tube of the First Affiliated Hospital of Anhui Medical University burn patients from January 2010 to November 2014 in order to analyze the vicissitude of bacteria and their drug resistance each year,and comparing with previous results of our unit.Results:The submission of specimens from 2010 to 2014 were isolated 542 strains from 283 cases of patients,among which male is more than female, male to female ratio was 2.04:1, mostly in young people;the high incidence of burns was May to October;the flame burns was the most in the injury factors,accounting for 44.17%,among which the electrical burn and hot objects scalding entirely occurred in male patients; but specimens from infants and adults in the composition of the detection of pathogens were different, the detection rate of Staphylococcus aureus was only lower than that of Pseudomonas aeruginosa,about 21.67%,and the rate of Acinetobacter baumannii is only 10.12%.In all detected strains,the number of Grame-negtive bacteria was far more than Gram-positive ones(the average separation rate of Grame-negtive bacteria accounted for 83.2%, Gram-positive ones accounted for 16.8%),among which Pseudomonas aeruginosa and Acinetobacter baumannii were the major strains in our burn wards in recent five years,the average detection rate of which was 33.03%,23.06% respectively,but previous results of our unit showed the highest detection rate of bacteria Pseudomonas aeruginosa,the detection rate of which was 23.30%,26.90% respectively, and Staphylococcus aureus, the detection rate of which was 17.20%,18.20% respectively.Clinical data of recent five years showed that the antibiotic resistance rates of Pseudomonas aeruginosa had declined only for ciprofloxacin, levofloxacin, aztreonam, piperacillin,most of the detected rate of antibiotic resistance were more than 70%, and were completely resistant for eftriaxone, kanamycin/clavulanic acid and so on;the antibiotic resistance rates of Acinetobacter baumannii had declined only for amikacin and cefoperazone/sulbactam,most of the detected rate of other antibiotic resistance were more than 90%,especially were completely resistant for were completely resistant for the detected antibiotics in 2014,such as Aztreonam, ceftriaxone, piperacillin, ceftazidime, cefotaxime, ciprofloxacin, cefepime, gentamicin, tobramycin, ampicillin/sulbactam, cotrimoxazolen; among which,the top five of Antibiotic-resistant rate of Staphylococcus were erythromycin (92.4%), oxacillin (84.6%), gentamicin (79.7%), clindamycin (76.7%), Central ciprofloxacin (75.6%), other antibiotic resistance rates was average about 50%, resistance rate for co-trimoxazole was 29.9%,there was no resistance to vancomycin, but clinical data has shown one case of linezolid resistance in 2010.Conclusions:There are many kinds of multi-drug resistant pathogenic bacteria for nosocomial infection in burn wards of the First Affiliated Hospital of Anhui Medical University,and strain changes. Resent five years clinical data shows that the Acinetobacter baumannii has replaced staphylococcus aureus to be the second major strains after Pseudomonas aeruginosa,and the drug resistance of bacteria is serious.Calling for strict disinfection and isolation measures, closely monitoring the bacterial drug resistance under the premise of standardize aseptic technique,appropriate use of antibiotics,to minimize the incidence of nosocomial infection in multi-drug resistant and increase clinical anti-infection treatment. |
PDF Full Text Request