| 孙 艳,严志新,段秀杰,丁先超.烧伤患者病原菌分布特点及医院感染危险因素分析[J].中国烧伤创疡杂志,2025,(2):125~128. |
| DOI： |
| 中文关键词: 烧伤 医院感染 危险因素 病原菌分布 |
| 英文关键词:Burns Nosocomial infection Risk factors Distribution of pathogenic bacteria |
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| 中文摘要: |
| 【摘要】 目的 分析烧伤患者病原菌分布特点及医院感染的相关危险因素。方法 选取 2015 年 1 月至2021 年 12 月江苏大学附属医院收治的 112 例烧伤患者作为研究对象, 收集患者病原菌分布情况、医院感染情况、性别、年龄等资料, 并根据医院感染情况将其分为感染组和未感染组, 分析烧伤患者病原菌分布特点及医院感染的相关危险因素。结果 112例烧伤患者共 105 例检出病原菌, 菌株数共347株,其中革兰氏阴性菌 244株(70.32%)、革兰氏阳性菌 102 株 (29.39%)、真菌1株 (0.29%), 标本来源于创面分泌物 122 株 (35.16%)?痰液 99 株 (28.53%)、全血63株(18.16%)、深静脉置管46株 (13.26%)、尿液8株 (2.31%)、其他 9 株(2.59%);结合临床表现判定其中 60 例为医院感染, 设为感染组，余45例判定为定植菌或污染菌, 与7例未检出病原菌者共同设为未感染组? 多因素Logistic回归分析结果显示, 住院时间≥30 d、高水平烧伤指数、使用呼吸机是烧伤患者医院感染的独立危险因素 (95%CI 为 3.502~ 38.874、1.006 ~ 1.072、1.593 ~ 25.530, P<0.001、P =0.022、P= 0.009)。结论 烧伤患者检出病原菌主要以鲍曼不动杆菌、肺炎克雷伯菌等革兰氏阴性菌以及金黄色葡萄球菌等革兰氏阳性菌为主，且住院时间、烧伤指数、呼吸机使用情况是其发生医院感染的独立影响因素。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the risk factors of distribution characteristics of pathogenic bacteria and nosocomial infection in burn patients. Methods 112 burn patients admitted to Affiliated Hospital of Jiangsu University from January 2015 to December 2021 were selected as research subjects. Data of these subjects were collected including distribution of pathogenic bacteria, nosocomial infection, sex, age, etc. The patients were divided into the infected group and the non-infected group according to the occurrence of nosocomial infection to analyze the risk factors of distribution characteris-tics of pathogenic bacteria and nosocomial infection in burn patients. Results A total of 347 strains were detected from 105 cases among the 112 burn patients, among which 244 strains ( 70. 32%) were gram?negative bacteria, 102 strains (29. 39%) were gram-positive bacteria, and 1 strain (0. 29%) was fungal. The specimens were derived from wound secretions 122 strains (35. 16%), sputum 99 strains (28. 53%), whole blood 63 strains (18. 16%), deep venous catheter 46 strains (13. 26%), urine 8 strains (2. 31%), and other sources 9 strains (2. 59%). Based on clinical manifestations, 60 cases were classified as nosocomial infections, being set as the infected group, while the remaining 45 cases were classified as colonized or contaminated bacteria, being set as the non-infected group with 7 cases without detected pathogens.Multivariate Logistic regression analysis showed that length of stay ≥30 days, high burn index, and use of ventilators were independent risk factors for nosocomial infections in burn patients ( 95% CI: 3. 502 - 38. 874, 1. 006 - 1. 072, 1. 593 -25. 530, P<0. 001, P= 0. 022, P = 0. 009). Conclusion The pathogenic bacteria detected in burn patients are mainly gram-negative bacteria such as Acinetobacter baumannii, Klebsiella pneumoniae, as well as gram-positive bacteria such as Staphylococcus aureus. Length of stay, burn index, and ventilator use are independent risk factors for the occurrence of nosocomial infection. |
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