摘要
目的探索深度烧伤患者血流感染的病原菌特点、耐药性分析及其与炎症介质水平变化的相关性。方法回顾性分析2019年9月—2022年12月本院收治的72例深度烧伤血流感染患者的临床资料,均进行病原菌调查,并分析耐药性,同时,在此时间段随机选择血培养阴性深度烧伤患者73例作为参照对象,进行炎症因子水平检测,比较血培养阴性、阳性患者的G+、G-菌组患者炎症因子水平。结果72例深度烧伤血流感染患者,经病原菌检测,培养出病原菌122株,其中革兰阳性菌15株(12.30%),革兰阴性菌87株(71.31%),真菌20株(16.39%),其中以鲍曼不动杆菌最为常见,所占比为29.51%,其次为肺炎克雷伯菌,所占比为18.03%。鲍曼不动杆菌对米诺环素、多黏菌素B有较高敏感性;肺炎克雷伯菌对氯霉素、米诺环素、头孢哌酮有较高敏感性。同时,G+、G-菌组患者WBC、CRP、PCT水平差异无统计学意义(P>0.05),血培养阳性WBC(11.74±5.44)×10^(9)个/L、CRP(129.22±47.46)mg/L、PCT(6.85±13.09)ng/ml水平高于血培养阴性(P<0.05)。结论深度烧伤患者血流感染后最常见的病原菌为鲍曼不动杆菌,其对米诺环素、多黏菌素B有较高敏感性,需根据耐药结果合理选择,同时,血清炎症因子表达与血流感染存在一定相关性,通过重点监测对疾病判断有一定意义。
Objective To explore the characteristics of pathogenic bacteria,drug resistance of bloodstream infections in patients with deep burn and the correlation with the level of inflammatory mediators.Methods The clinical data of 72 patients with deep burn bloodstream infection who were admitted to Zhengzhou first people's hospital from September 2019 to December 2022 were retrospectively analyzed,all of which were investigated for pathogenic bacteria and analyzed for drug resistance.Meanwhile,73 patients suffer from deep burn with negative blood cultures were randomly selected as reference objects during this period,the levels of inflammatory factors were detected.The levels of inflammatory factors in patients with negative blood cultures,positive blood cultures with G+and positive blood cultures G-bacteria groups were compared.Results Among 72 patients with deep burn bloodstream infection,122 strains of pathogenic bacteria were detected,including 15 Gram-positive bacteria(12.30%),87 Gram-negative bacteria(71.31%),and 20 fungi(16.39%).Acinetobacter baumannii was the most common pathogen,accounting for 29.51%,followed by Klebsiella pneumoniae,accounting for 18.03%.Acinetobacter baumannii showed high sensitivity to minocycline and polymyxin B.Klebsiella pneumoniae was highly sensitive to chloramphenicol,minocycline,and cefoperazone.There were no statistically significant differences in WBC,CRP,and PCT levels between G+and G-bacteria groups(P>0.05).The levels of WBC[(11.74±5.44)×10^(9)/L],CRP[(129.22±47.46)mg/L],and PCT[(6.85±13.09)ng/ml]in the blood culture-positive group were significantly higher than those in the blood culture-negative group(P<0.05).Conclusions Acinetobacter baumannii is the most common pathogen causing bloodstream infection in deep burn patients,showing high sensitivity to minocycline and polymyxin B.Drug selection should be based on resistance profiles.Serum inflammatory factor levels are correlated with bloodstream infection,and monitoring these markers is valuable for clinical assessment.
作者
尚米米
曹大勇
马春红
Shang Mimi;Cao Dayong;Ma Chunhong(Department of Clinical Laboratory,Zhengzhou First People's Hospital,Zhengzhou,Henan 450004,China;Burn Reconstruction(Microsurgery)Ward,Zhengzhou First People's Hospital,Zhengzhou,Henan 450004,China)
出处
《齐齐哈尔医学院学报》
2025年第16期1515-1519,共5页
Journal of Qiqihar Medical University
基金
2020年度河南省医学科技攻关计划联合共建项目(LHGJ20200698)。
关键词
深度烧伤
血流感染
病原菌
耐药性
炎症介质
相关性
Deep burn
Bloodstream infection
Pathogenic bacteria
Drug resistance
Inflammatory mediators
Correlation
