Sewunet Tsegaye, Demissie Yohanes, Mihret Adane, Abebe Tamrat
Department of Microbiology, Jimma University, Jimma, Ethiopia.
Ethiop J Health Sci. 2013 Nov;23(3):209-16. doi: 10.4314/ejhs.v23i3.3.
Infection is a common cause of morbidity and mortality in burn patients. Clinical diagnosis of bacteremia and/or sepsis in burn patients is difficult for a number of reasons. It could be symptomatic and/or asymptomatic as a result of immune deficiency secondary to thermal injury.
A cross sectional study was conducted at Yekatit 12 Hospital Burn Center. Blood specimen and wound swab were collected from burn patients and were cultured by conventional method. Sensitivity/susceptibility pattern of the isolates was determined by disc diffusion method. Some of the risk factors of bacteremia like prior antibiotic use and total body surface area burn were also determined.
Fifty patients were enrolled in the study of whom 21(42%) were found bacteremic. Five different bacteria were isolated from blood specimen. Coagulase negative Staphylococci, 9(42.8%), S. aureus, 8(38.2%), Bacillus spps, 2(9.52%), K. pneumoniae, 1(4.8%), and P. aeruginosa, 1(4.8%), were frequent isolates. From wound swab, S. aureus, (34.04%), and P. aeruginosa, (31.8%), were predominant. Antimicrobial resistance was observed for Ampicillin, (77.4%), Doxycycline, (74.0), Nalidixic acid, (70.5%), Penicillin G, (68.2%), and tetracycline, (67.5%). Total body surface area of burn ≥ 15% was found as a risk factor for bacteremia.
Bacteremia was detected at a rate of 42% among burn patients. Frequent isolates were S. aureus, (34.04%), and P. aeruginosa, (31.8%). About 82.16% of the isolates showed multiple resistances. In light of our findings, regular antibiotic resistance test has to be done for each patient in order to select an appropriate antimicrobial agent.
感染是烧伤患者发病和死亡的常见原因。由于多种原因,烧伤患者菌血症和/或脓毒症的临床诊断较为困难。热损伤继发免疫缺陷可能导致其有症状和/或无症状。
在耶卡提特12医院烧伤中心进行了一项横断面研究。从烧伤患者采集血液标本和伤口拭子,采用常规方法进行培养。通过纸片扩散法测定分离株的敏感性/药敏模式。还确定了一些菌血症的危险因素,如先前使用抗生素情况和烧伤总面积。
50例患者纳入研究,其中21例(42%)被发现有菌血症。从血液标本中分离出5种不同细菌。凝固酶阴性葡萄球菌9例(42.8%)、金黄色葡萄球菌8例(38.2%)、芽孢杆菌属2例(9.52%)、肺炎克雷伯菌1例(4.8%)、铜绿假单胞菌1例(4.8%)为常见分离株。伤口拭子中,金黄色葡萄球菌(34.04%)和铜绿假单胞菌(31.8%)占主导。氨苄西林(77.4%)、多西环素(74.0%)、萘啶酸(70.5%)、青霉素G(68.2%)和四环素(67.5%)存在耐药情况。烧伤总面积≥15%被发现是菌血症的危险因素。
烧伤患者菌血症检出率为42%。常见分离株为金黄色葡萄球菌(34.04%)和铜绿假单胞菌(31.8%)。约82.16%的分离株表现出多重耐药。根据我们的研究结果,为选择合适的抗菌药物,必须对每位患者定期进行抗生素耐药性检测。