烧伤患者创面感染情况及影响因素分析

doi:10.12183/j.scjpm.2023.1229

摘要/Abstract

摘要： 目的探讨烧伤患者创面感染的发生情况及病原菌特点,并分析影响创面感染的相关因素。方法以2019年1月至2021年12月武汉市2家三甲医院收治的烧伤住院患者作为研究对象,采用全自动微生物分析仪检测创面感染患者的病原菌,采用自制信息收集表收集烧伤患者基本信息、烧伤情况、合并慢性疾病及治疗情况等,采用描述性分析方法对烧伤患者创面感染情况进行分析,并采用单、多因素分析方法对创面感染影响因素进行分析。结果本研究共收集烧伤患者1 532例,共287例发生创面感染,感染率18.73%。287例感染患者共检出369株病原菌,其中革兰阴性菌248株（67.21%）,居前3位的为铜绿假单胞菌89株（24.12%）、鲍曼不动杆菌50株（13.55%）、肺炎克雷伯杆菌32株（8.67%）;革兰阳性菌121株（32.79%）,居前3位的为金黄色葡萄球菌53株（14.36%）、表皮葡萄球菌43株（11.65%）、粪肠球菌9株（2.44%）。多因素logistic回归分析结果显示,结果显示烧伤面积（10%~30% OR=1.932,31%~49% OR=4.352,≥50%OR=9.655）、烧伤深度（深Ⅱ度OR=2.048,Ⅲ度OR=4.170）、合并吸入性损伤（OR=2.542）、早期休克（OR=4.593）、合并糖尿病（OR=7.708）、抗菌药物使用≥3种（OR=4.705）、住院时间（15~29 d OR=9.289、≥30 d OR=9.787）,入住ICU（OR=2.770）是烧伤患者创面感染的影响因素。结论烧伤患者创面感染与烧伤面积、烧伤深度等多种因素密切相关,感染病原菌以革兰阴性菌为主,住院期间需采取针对性措施降低感染风险,预防创面感染。

关键词: 烧伤, 创面感染, 病原菌, 影响因素

Abstract: Objective To investigate the occurrence of wound infection and the characteristics of pathogenic bacteria in burn patients, and analyze the relevant factors affecting wound infection. Methods The hospitalized burn patients admitted to two Grade A hospitals in Wuhan from January 2019 to December 2021 were selected as the subjects. Automatic microbial analysis was used to detect pathogenic bacteria in patients with wound infection, the self-made information collection form was used to collect basic information, burn condition, combined chronic diseases, and treatment of burn patients. The descriptive analysis method was used to analyze the wound infection of burn patients, and univariate and multivariate analysis methods were used to analyze the influencing factors of wound infection. Results In this study, a total of 1 532 burn patients were collected, and 287 cases developed wound infection, with an infection rate of 18.73%. A total of 369 strains of pathogenic bacteria were detected in 287 infected patients, including 248 strains of Gram-negative bacteria （67.21%）, the top three strains were Pseudomonas aeruginosa （89 strains, 24.12%）, Acinetobacter baumannii （50 strains, 13.55%）, and Klebsiella pneumoniae （32 strains, 8.67%）; There were 121 strains of Gram-positive bacteria （32.79%）, the top three strains were Staphylococcus aureus （53 strains, 14.36%）, Staphylococcus epidermidis （43 strains, 11.65%）, and Enterococcus faecalis （9 strains, 2.44%）. The results of multivariate logistic regression analysis showed that the burn area （10%-30% OR=1.932, 31%-49% OR=4.352, ≥50% OR=9.655）, burn depth （depth Ⅱ degree OR=2.048, Ⅲ degree OR=4.170）, inhalation injury （OR=2.542）, early shock （OR=4.593）, diabetes mellitus （OR=7.708）, ≥3 kinds of antibiotics were used （OR=4.705）, length of stay （15-29 days OR=9.289, ≥30 days OR=9.787）, stay in ICU （OR=2.770） were the influencing factors of wound infection in burn patients. Conclusions The wound infection of burn patients is closely related to the burn area, burn depth, and other factors, and the pathogenic bacteria are mainly Gram-negative bacteria. Targeted measures should be taken during hospitalization to reduce the risk of infection and prevent wound infection.

Key words: Burn, Wound infection, Pathogenic bacteria, Influencing factor

中图分类号:

R446.5

肖盼, 张宇琼. 烧伤患者创面感染情况及影响因素分析[J]. 华南预防医学, 2023, 49(10): 1229-1232.

XIAO Pan, ZHANG Yuqiong. Analysis of wound infection and its influencing factors in burn patients[J]. South China Journal of Preventive Medicine, 2023, 49(10): 1229-1232.

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