摘要
目的探讨引起烧伤创面病原菌感染发生的相关因素及病原菌分布状况,为烧伤感染的预防及治疗提供参考。方法收集2012年1月-2015年12月在医院诊治的212例烧伤患者临床资料,回顾性分析创面病原菌培养结果及引起感染的相关因素。结果 212例患者发生创面感染者164例,感染率为77.36%;创面分泌物中培养出185株病原菌,其中革兰阴性菌131株占70.81%,革兰阳性菌49株占26.49%,真菌5株占2.70%,感染病原菌以铜绿假单胞菌、鲍曼复合醋酸钙不动杆菌、金黄色葡萄球菌为主,分别占18.38%、15.14%、11.89%;单因素及多因素logistic回归分析显示,烧伤面积越大、烧伤程度越深、预防使用抗菌药物种类越多感染率越高(P<0.05),入院后预防使用抗菌药物、合并休克、平时有自购抗菌药物滥用习惯、有长期服用糖皮质激素治疗疾病史等因素时感染率高(P<0.05)。结论烧伤发生后创面感染率极高,感染病原菌主要是革兰阴性菌,引起烧伤感染的因素较多,应针对性的进行干预以降低感染发生。
OBJECTIVE To explore the related factors for burn wound infections and analyze the distribution of pathogens so as to provide guidance for prevention and treatment of the burn wound infections. METHODS The clinical data were collected from 212 burn wound patients who were treated in hospitals from Jan 2012 to Dec 2015. The result of culture of wound specimens and the related factors for the infections were retrospectively ana- lyzed. RESULTS The wound infections occurred in 164 of 212 patients, with the infection rate 77.36%. A total oS 185 strains of pathogens were isolated from the wound secretions specimens, including 131 （70.81%） strains of gram-negative bacteria, 49 （26.49%） strains of gram-positive bacteria, and 5 （2. 70%） strains of fungi. The Pseudomonas aeruginosa , Acinetobacter baumannii , and Staphylococcus aureus were dominant among the pathogens causing the infections, accounting for 18.38%, 15.14%, and 11.89%, respectively. The univariate and multivariate logistic regression analysis showed that the larger the area of burn wound, the greater the degree of burn, the more types the prophylactic use of antibiotics, the higher the incidence of the infections was （P〈0.05）. The infection rate was high in the patients who used prophylactic antibiotics, had complication with shock, had habit of abuse of antibiotics, and had the history of long-term administration of glucoeorticoids for treatment of disease （P 〈0.05）. CONCLUSION The incidence of wound infections is extremely high in the patients with burn wound. The gram-negative bacteria are dominant among the pathogens causing the infections. There are a variety of factors for the infections. It is necessary to take targeted interventions so as to reduce the infection rate.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第2期345-347,共3页
Chinese Journal of Nosocomiology
基金
河北省医学科学研究重点课题(20150049)
关键词
烧伤
病原菌
感染
Burn wounds Pathogen
Infection
