摘要
目的探讨重度烧伤患者细菌感染的菌群分布并分析其影响因素。方法选取我院2017年1月-2019年1月收治的重度烧伤患者212例,普通培养烧伤后10~15 d创面分泌物,观察细菌感染菌群分布情况,并从性别、年龄、烧伤深度、烧伤面积、低蛋白血症、糖尿病、早期休克、延迟复苏、血红蛋白尿、吸入性损伤、抗菌药物使用等方面分析重度烧伤患者感染的影响因素。结果 212例重度烧伤患者中有89例患者发生创面感染,感染率为41.98%。89例发生创面细菌感染患者中:26例感染鲍氏不动杆菌,占29.21%;20例感染金黄色葡萄球菌,占22.47%;17例感染铜绿假单胞菌,占19.10%;12例感染肺炎克雷伯菌,占13.48%;8例感染大肠杆菌,占8.99%;4例感染变形杆菌,占4.49%;2例感染不动杆菌,占2.25%。影响重度烧伤患者细菌感染的单因素有烧伤面积、低蛋白血症、糖尿病、早期休克、延迟复苏、吸入性损伤(P<0.05)。烧伤面积大、有低蛋白血症、有糖尿病、存在早期休克、延迟复苏现象、合并吸入性损伤是重度烧伤患者细菌感染独立危险因素(P<0.05)。结论重度烧伤患者易发生细菌感染,感染影响因素有烧伤面积、低蛋白血症、糖尿病、早期休克、延迟复苏、吸入性损伤,临床应针对危险因素积极采取防治措施,控制细菌感染发生率,促进患者康复。
Objective To observe the pathogens distribution and influencing factors of bacterial infection in patients with severe burns. Methods Two hundred and twelve patients with severe burn admitted to our hospital from January 2017 to January 2019 were selected. Wound secretions at 10 to 15 days after burns were cultured, and the pathogen distribution was observed. The influencing factors of infection were analyzed in terms of gender, age, burn depth, burn area, hypoproteinemia, diabetes, early shock, delayed resuscitation, hemoglobinuria, inhalation injury and antimicrobial use. Results Among the 212 patients, 89(41.98%) had wound infection, including 26 cases with Acinetobacter baumannii infection(29.21%), 20 cases with Staphylococcus aureus infection(22.47%), 17 cases with Pseudomonas aeruginosa infection(19.10%), 12 cases with Klebsiella pneumoniae infection(13.48%), 8 cases with Escherichia coli infection(8.99%), 4 cases with Proteus infection(4.49%), and 2 cases with Acinetobacter infection(2.25%). The single factors affecting bacterial infection in patients with severe burns were burn area, hypoproteinemia, diabetes, early shock, delayed resuscitation, and inhalation injury(P<0.05). Large burn area, hypoproteinemia, diabetes, early shock, delayed resuscitation, and inhalation injury were independent risk factors for bacterial infection in patients with severe burn(P<0.05). Conclusion Severe burn patients have high risks of bacterial infection, and the influential factors of infection include burn area, hypoalbuminemia, diabetes, early shock, delayed resuscitation and inhalation injury. Clinical measures should be taken against the risk factors to control the incidence of bacterial infection, and promote the recovery of patients.
作者
贾宇博
党连强
JIA Yu-bo;DANG Lian-qiang(Deparment of Burn and Plastic Surgery,Liaoyang Central Hospital,Liaoyang,Liaoning 111000,China)
出处
《中国微生态学杂志》
CAS
CSCD
2021年第4期446-449,共4页
Chinese Journal of Microecology
关键词
重度烧伤
细菌感染
菌群分布
影响因素
Severe burns
Bacterial infection
Flora distribution
Influencing factor
作者简介
通信作者:贾宇博(1981-),男,硕士,副主任医师,主要从事烧伤创面修复和瘢痕整形治疗、难愈性创面及窦道的修复治疗研究,E-mail:zuiixin3@163.com。
