不同类型创面病原菌定植和感染差异性研究

Analysis of the difference of pathogenic bacteria colonization and infection between two types of wound

目的比较两种类型创面病原菌定植和感染的差异性,为临床防治提供理论依据。方法通过创面分泌物细菌培养、鉴定以及药敏试验,观察比较某医院烧伤整形外科住院患者不同创面病原菌定植感染特征。结果从两种类型创面采集分泌物494例次,分离出病原菌368株,其中多重耐药菌258株,占检出总菌数的70.11%。难愈性创面分泌物中病原菌检出率为85.23%,其中多重耐药菌比例为75.85%,以革兰阴性菌为主;非难愈性创面分泌物中病原菌检出率为51.56%,多重耐药菌比例为55.34%,以革兰阳性菌为主。多因素Logistic回归分析显示。住院史和本次住院超过2周是难愈性创面病原菌定植感染的独立危险因素。结论难愈性创面分泌物病原菌检出率、多重耐药菌比例均高于非难愈性创面,必须加强难愈性创面消毒等防控措施,降低病原菌定植率。

Objective To analyze the difference of pathogenic bacteria colonization and infection between refractory and non-refractory wound,so as to provide theoretical foundation for prevention and treatment wound bacterial. Methods Results of bacteria identification,drug sensitivity and clinical observation were used to detection and analysis for wound pathogenic bacteria colonization and infection patients in a hospital. Results 494 clinical samples were analyzed and 368 stains of pathogens were isolated. 70. 11% pathogens（ 258 stains） were multiple drug-resistant organisms（ MDROs）. Detection rate of pathogen in refractory wound was 85. 23% and the proportion of MDROs was 75. 85% in refractory wound. The main pathogenic was Gram negative bacilli in refractory wound. Detection rate of pathogen in refractory wound was 51. 56% and the proportion of MDROs was 55. 34% in non-refractory wound,and the main pathogenic was Gram positive cocci. History of hospitalization and hospital time more than 2 weeks were the strongest predictor for refractory wound pathogenic bacteria colonization and infection after multiple factors logistic regression analysis. Conclusion There are higher detection rate of pathogen and higher proportion of MDROs in refractory wound. It needs to strengthen the prevention and treatment measures for refractory wound pathogenic bacteria colonization and infection.