烧伤创面细菌生态和抗生素治疗

The main factors influencing the bacterial ecology on burn wound are the selection of antibacterial agents and systemic antibiotic. Some antibacterial agents more active against P. aeruginosa were developed in 1960s,and the detection rate of P. aeruginosa on burn wound has been declined, and the detection rate of Enter obacter iaceae species and Acineto bacter SPP. has been raised since then. In 1990s,the third generation Cephalospor in was widely used in burn unit and the detection rate of staphylococcuse aureus showed an increased trend. Especially, the positive rate of MRSA was increased significantly. Under the selection pressure of antibacterial agent, the resistant strains are rapidly increased and the antibiotics against opportunistic pathogen on burn wound should be selected continuously. Finally, the bacterial ecology pattern on burn wound is changing incessantly. The result is that the prevalence of infection of muhi-drug resistance strains and opportunistic pathogen appears on burn wound. In order to optimize the antibiotic therapy, the bacterial ecology pattern on burn wound has to be investigated, and the dominant pathogen including invasive and currently prevailing strains in the burn unit also should always be surveyed. In addition, we also should know the mechanisms of bacterial resistance. The .regular surveillance of antibiotic resistance in the clinical isolates is the most important and valuable for understanding the trend of bacterial resistance. The antibiotic therapy should be decided according to the result of susceptibility tests.