摘要
目的探讨不同烧伤面积患者创面感染病原菌的分布特征及其对常用抗菌药物的耐药性,为临床合理用药提供依据,以改善烧伤患者的治疗效果和预后。方法收集2020~2023年某两家医院烧伤患者的病例信息,根据烧伤面积占体表总面积(TBSA)的比例分为3组:<10%TBSA组、10%~50%TBSA组、>50%TBSA组。分析不同组别患者创面感染病原菌的分布情况,并采用χ2检验比较3组病原菌的耐药性差异。结果共分离出1514株创面感染病原菌,革兰阳性菌占54.5%(825株),革兰阴性菌占45.5%(689株)。其中<10%TBSA组609株,10%~50%TBSA组537株,两组均以金黄色葡萄球菌最为常见,分别占比45.2%、33.3%;>50%TBSA组368株,以铜绿假单胞菌(20.9%)占比最高。耐药性分析显示,>50%TBSA组病原菌对于大部分常用抗菌药物的耐药率升高,其中金黄色葡萄球菌对苯唑西林的耐药率为77.6%;铜绿假单胞菌对碳青霉烯类的耐药率为35.1%,均明显高于另外两组(P<0.05)。结论不同烧伤面积患者创面感染病原菌的分布存在差异,随着烧伤面积的增加,病原菌的耐药率以及多重耐药菌的检出率呈现出一定的升高趋势。临床治疗应实时关注不同烧伤程度患者的病原菌分布特点及耐药性变化,合理化地选择抗菌药物,以达到更好的治疗效果。
Objective The current study aims to investigate the distribution characteristics of pathogenic bacteria in wound infections among patients with different burn areas and their resistance to commonly used antibiotics,so as to provide a reference basis for rational clinical medication to improve treatment outcomes and prognosis for burn patients.Methods Burn patients admitted to two hospitals between 2020 and 2023 were selected for the study and divided into three groups based on the percentage of total body surface area(TBSA)affected by burns:<10%TBSA group,10%-50%TBSA group,and>50%TBSA group.The distribution of pathogenic bacteria in wound infections among these different groups was collected and analyzed,and the chi-square(χ^(2))test was conducted to evaluate differences in drug resistance among the three groups.Results A total of 1514 strains of pathogenic bacteria were isolated from wound infections,with Gram-positive bacteria accounting for 54.5%(825 strains)and Gram-negative bacteria for 45.5%(689 strains).There were 609 strains in the<10%TBSA group and 537 strains in the 10%-50%TBSA group.Both groups were most infected with Staphylococcus aureus,accounting for 45.2%and 33.3%,respectively.In the>50%TBSA group,there were 368 strains,with Pseudomonas aeruginosa having the highest proportion at 20.9%.Drug resistance analysis showed that the drug resistance rate of the pathogens in the>50%TBSA group to most used antibacterial drugs increased.Among them,the resistance rate of Staphylococcus aureus to oxacillin was 77.6%,and the resistance rate of Pseudomonas aeruginosa to carbapenems was 35.1%,both significantly higher than the other two groups(P<0.05).Conclusion The distribution of pathogenic bacteria in wound infections varies among patients with different burn areas.As the burn area increases,the drug resistance rate of pathogenic bacteria and the detection rate of multi-drug-resistant bacteria have shown a certain upward trend.Clinical treatment should focus on the distribution characteristics and resistance patterns of pathogenic bacteria in patients with different burn severities.Physicians should rationally select antimicrobial drugs to improve treatment efficacy.
作者
邓露露
高洁
DENG Lulu;GAO Jie(Department of Laboratory Medicine,Guangzhou Red Cross Hospital,Guangzhou 510220,China;Department of Laboratory Medicine,Wuhan Third Hospital,Wuhan,430060,China)
出处
《标记免疫分析与临床》
2025年第7期1424-1430,共7页
Labeled Immunoassays and Clinical Medicine
基金
广州市科技计划项目(编号:2024A03J0602)。
关键词
烧伤面积
病原菌
创面感染
耐药性分析
Burn area
Pathogenic bacteria
Wound infection
Drug resistance analysis
