[Analysis of bacterial resistance to antibiotics in a burn ward].

OBJECTIVE: To analyze the bacterial resistance to antibiotics in a burn ward in the past 4 years.

METHODS: Six hundred and fifty strains of bacteria were isolated from the wounds and blood of burn patients admitted to our hospital in recent 4 years. Slip agar diffusion method was employed to carry out antibiotic sensitivity test, and the results were interpreted according to the NCCLS criteria. Extended spectrum beta -- lactamases (ESBLs) were detected by double slips synergic test in 45 strains of Klebsiella Pneumoniae.

RESULTS: Only vancomycin was effective for staphylococcus aureus, and Imipenem was effective for E. coli, E. cloacae and K. pneumoniae. But P. aeruginosa was only susceptible to polymyxin -- B. In addition, Thirty -- eight out of 45 strains of K. pneumoniae were ESBLs positive with the incidence of 84.4%.

CONCLUSION: The high resistance of the bacteria to most antibiotics in our burn ward might be related to the high production of beta -- lactamases and especially ESBLs. Imipenem remained stable to ESBLs and remained highly effective for most bacteria. But antibiotics with beta -- lactamases inhibitor became less effective in recent years. The resistance rate of P. aeruginosa to Imipenem increased gradually in recent years. This might be due to the abuse of Tienam in burn patients, which stimulated the bacteria to produce a new metallic beta -- lactamases transfected by plasmid, decreasing the production of bacterial outer membrane proteins and inducing a change in membranous permeability.