烧伤创面感染病原学特点及影响因素分析

Etiological characteristics influencing factors for burn wound infection

目的分析烧伤创面检出病原菌情况,探究创面感染的影响因素,为烧伤创面感染的预防提供参考。方法采用回顾性分析的方法,抽取医院2016年2月-2018年2月收治的58例烧伤患者临床资料,记录患者入院后创面病原菌检出情况,分析烧伤患者创面感染的影响因素。结果 58例烧伤患者住院期间共检出96株病原菌,其中革兰阴性菌65株占67.71%;58例烧伤患者在治疗期间共发生29例感染,感染率为50.00%。其中第3天发生1例(1.72%),第4~7天发生6例(10.34%),第8~14天发生14例(24.14%),第15~21天发生8例(13.79%);多因素Logistic回归分析结果,烧伤深度深、烧伤程度重、烧伤类型为火焰烧伤、烧伤面积大、有合并症、侵入性操作多、联合使用抗菌药物、创面用药种类是烧伤患者治疗过程中感染的影响因素(P<0.05)。结论烧伤患者创面病原菌检出率随着住院时间的延长呈递增趋势,烧伤类型、烧伤程度、烧伤深度、创面面积、抗菌药物联合使用、侵入性操作过多等均是导致患者创面感染的影响因素。

OBJECTIVE To investigate the distribution of pathogens isolated from the patients with burn wounds and explore the influencing factors for wound infection so as to provide guidance for prevention of the burn wound infection.METHODS The clinical data of 58 burn wound patients who were treated in hospitals from Feb 2016 to Feb 2018 were retrospectively analyzed,the pathogens were isolated and recorded after the admission,and the influencing factors for the wound infection in the burn patients were recorded.RESULTS A total of 96 strains of pathogens were isolated from the 58 burn patients during the hospital stay,65(67.71%)of which were gram-negative bacteria.Totally 29 of 58 burn patients had infection during the hospital stay,with the infection rate 50.00%.There was 1(1.72%)case of infection on the 3 rd day of admission,6(10.34%)cases of infection on 4 th-7 th day of admission,14(24.14%)cases of infection on 8 th-14 th day of admission and 8(13.79%)cases of infection on 15 th-21 st day of admission.The result of multivariate logistic regression analysis showed that the influencing factors for the infection included deep burn wound,severe burn wound,flame burn,large burn area,complications,multiple invasive operations,combined use of antibiotics and type of drug for wound surface(P<0.05).CONCLUSION The isolation rate of pathogens is increased with the extension of length of hospital stay of the burn wound patients.The types of burn wound,severity of burn wound,depth of burn wound,area of wound,combined use of antibiotics and multiple invasive operations are the influencing factors for the wound infection.