1995 - 2001年一家三级医院感染伤口中细菌病原体的流行情况：趋势有任何变化吗？

Prevalence of bacterial pathogens in infected wounds in a tertiary hospital, 1995-2001: any change in trend?

作者信息

Thanni Lateef O A, Osinupebi Olubunmi A, Deji-Agboola Mope

机构信息

Dept. of Orthopedics and Traumatology, College of Health Sciences, Olabisi Onabanjo University, P.M.B. 2022, Sagamu, Ogun State.

出版信息

J Natl Med Assoc. 2003 Dec;95(12):1189-95.

PMID:14717475

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2594861/

Abstract

BACKGROUND

Wound care is a very important aspect of surgical care. Knowledge of the epidemiology of bacterial pathogens associated with infected wounds is critical in formulating policies on infection control.

OBJECTIVE

To determine the prevalence of bacterial pathogens in wounds from various units of a Nigerian tertiary hospital orthopedics and traumatology department, as well as changes over time, if any, in the prevalence rates.

METHODS

A retrospective study was conducted using laboratory records from 1995 to 2001.

RESULTS

670 bacterial isolates from 629 patients were studied. The most common isolates were Pseudomonas spp.-29.9%, and Staphylococcus aureus (S. aureus)--27.5%. Others were Klebsiella spp.-18.5%, Proteus spp.--15.1%, and Escherichia coli (E. coli)--7%. The least common were Streptococci--2%, and Enterococci--0.3%. Pseudomonas spp. accounted for 33% of isolates in the adult wards, while S. aureus was 21% and E. coli 8%. The pattem is similar in the pediatric ward (33.9%, 23.7%, and 8.5%, respectively) and Intensive Care Unit (ICU) (40%, 6.7%, and zero, respectively). S. aureus was the most common isolate from the orthopedic clinics (OPD) 40%, and the A&E (35%), followed by pseudomonas spp.-25.4% and 19%, respectively. The odds of a wound being infected with Gram-negative bacilli among inpatients compared with outpatients is 2.44 (95% CL = 1.72-3.47; P = 0.0000003) Between 1995 and 2001, the prevalence of Gram-positive bacteria decreased, while that of Gram-negative bacilli increased. The prevalence of Pseudomonas spp. and S. aureus also increased.

CONCLUSION

Wounds from patients in the orthopedics and trauma services are more frequently infected with Gram-negative bacilli than by Gram-positive bacteria. The prevalence of the former is higher in the ICU and least in the OPD. Pseudomonas spp. was the most common isolate. It was more common among inpatients, while S. aureus was more common among outpatients. The prevalence of Pseudomonas spp. in particular and Gram-negative bacilli in general is increasing.

摘要

背景

伤口护理是外科护理的一个非常重要的方面。了解与感染伤口相关的细菌病原体流行病学对于制定感染控制政策至关重要。

目的

确定尼日利亚一家三级医院骨科和创伤科各科室伤口中细菌病原体的流行情况，以及流行率是否随时间发生变化（如有）。

方法

采用1995年至2001年的实验室记录进行回顾性研究。

结果

对629例患者的670株细菌分离株进行了研究。最常见的分离株是铜绿假单胞菌属——29.9%，金黄色葡萄球菌——27.5%。其他的有克雷伯菌属——18.5%，变形杆菌属——15.1%，以及大肠杆菌——7%。最不常见的是链球菌——2%，肠球菌——0.3%。铜绿假单胞菌属在成人病房的分离株中占33%，而金黄色葡萄球菌为21%，大肠杆菌为8%。儿科病房（分别为33.9%、23.7%和8.5%）和重症监护病房（ICU）（分别为40%、6.7%和零）的情况类似。金黄色葡萄球菌是骨科门诊（OPD）最常见的分离株（40%），也是急诊室（A&E）最常见的分离株（35%），其次是铜绿假单胞菌属——分别为25.4%和19%。住院患者伤口感染革兰氏阴性杆菌的几率与门诊患者相比为2.44（95%置信区间=1.72 - 3.47；P = 0.0000003）。1995年至2001年期间，革兰氏阳性菌的流行率下降，而革兰氏阴性杆菌的流行率上升。铜绿假单胞菌属和金黄色葡萄球菌的流行率也有所上升。