Tekin Recep, Dal Tuba, Bozkurt Fatma, Deveci Ozcan, Palanc Ylmaz, Arslan Eyüp, Selçuk Caferi Tayyar, Hoşoğlu Salih
From the Departments of *Infectious Disease and Clinical Microbiology, †Medical Microbiology, ‡Public Health, and §Plastic Surgery, Dicle University School of Medicine, Diyarbakir, Turkey.
J Burn Care Res. 2014 Jan-Feb;35(1):e73-80. doi: 10.1097/BCR.0b013e31828a493f.
Acinetobacter baumannii infections in burn patients may lead to delays in wound healing, graft losses, and development of sepsis. Determining the risk factors for multidrug resistant A. baumannii (MDR-AB) infections is essential for infection control. In the present study, the authors aimed to evaluate risk factors for wound infections caused by A. baumannii in burn patients. The study was conducted at Dicle University Hospital Burn Center, from April 2011 to July 2012, to investigate the risk factors for MDR-AB infections. The data of both the case and control group patients and the result of wound cultures were recorded on a daily basis, on individual forms given for each patient, and analyzed. A total of 30 cases infected with MDR-AB, and 60 uninfected control patients, were included in the study. The mean age (±SD) was 7.7 ± 15.4 years in infected patients and 11.4 ± 16.5 years in uninfected patients. The mean total burn surface area was 13.5 ± 10.9% in uninfected patients and 34.7 ± 16.2% in infected patients. The mean total burn surface area, the abbreviated burn severity index, acute physiological and chronic health evaluation II score, day of admission to hospital, length of hospital stay, first excision day, prior usage of third-generation cephalosporins, and stay in intensive care unit of the infected patients were significantly higher (P < .001) than those of patients without infection. Univariate analysis found that high acute physiological and chronic health evaluation II score, first excision time of wound, invasive device usage, admission day to hospital, and prior usage of broad-spectrum antibiotics were risk factors for nosocomial infections. This study showed that multiple factors contribute to multidrug resistance in A. baumannii. A combination of an early diagnosis of wound infections, appropriate antimicrobial treatments, surgical debridement, and early wound closure may be effective in the management.
鲍曼不动杆菌感染烧伤患者可能导致伤口愈合延迟、植皮失败和败血症的发生。确定多重耐药鲍曼不动杆菌（MDR-AB）感染的危险因素对于感染控制至关重要。在本研究中，作者旨在评估烧伤患者鲍曼不动杆菌引起伤口感染的危险因素。该研究于2011年4月至2012年7月在迪克莱大学医院烧伤中心进行，以调查MDR-AB感染的危险因素。病例组和对照组患者的数据以及伤口培养结果每天记录在为每位患者提供的单独表格上，并进行分析。该研究共纳入30例MDR-AB感染患者和60例未感染的对照患者。感染患者的平均年龄（±标准差）为7.7±15.4岁，未感染患者为11.4±16.5岁。未感染患者的平均烧伤总面积为13.5±10.9%，感染患者为34.7±16.2%。感染患者的平均烧伤总面积、简化烧伤严重程度指数、急性生理与慢性健康状况评估II评分、入院天数、住院时间、首次清创日、第三代头孢菌素的既往使用情况以及重症监护病房停留时间均显著高于（P<0.001）未感染患者。单因素分析发现，急性生理与慢性健康状况评估II评分高、伤口首次清创时间、侵入性器械使用、入院日以及广谱抗生素的既往使用是医院感染的危险因素。本研究表明，多种因素导致鲍曼不动杆菌多重耐药。伤口感染的早期诊断、适当的抗菌治疗、手术清创和早期伤口闭合相结合可能对治疗有效。
