Ramirez-Blanco Carlos Enrique, Ramirez-Rivero Carlos Enrique, Diaz-Martinez Luis Alfonso, Sosa-Avila Luis Miguel
Division of Plastic and Reconstructive Surgery, Burn Center, University Hospital of Santander, Universidad Industrial de Santander, Colombia.
University Hospital of Santander, Universidad Industrial de Santander, Colombia.
Burns. 2017 May;43(3):642-653. doi: 10.1016/j.burns.2016.07.008. Epub 2017 Feb 6.
Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection.
To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS).
Burn patients hospitalized in the HUS from January 1 to December 2014 were followed. Medical information regarding infections, laboratory and pathology reports were obtained. Statistical analysis with measures of central tendency, proportions, global and specific incidence density plus overall and specific incidence was obtained. For the microbiological profile proportions were established.
402 burn patients were included, 234 (58.2%) men and 168 (41.8%) women, aged between 6 days and 83 years, median 12.5 years. The burn agents include scald (52.5%), fire (10.0%), gasoline (9.2%), electricity (7.5%), among others. Burn area ranged from 1% to 80% TBS. Cumulative mortality was 1.5%. 27.8% of burned patients had one or more infections. Identified infections include folliculitis (27.0%), urinary tract infection (19.0%), infection of the burn wound (10.4%), pneumonia (8.6%), Central venous catheter (7.4%), bloodstream infection (7.4%) and skin grafts infection (4.3%) among others. Bacteria were responsible for 88.5% of the cases and fungi 11.5%. The most frequently isolated germs were P. aeruginosa, A. baumannii, E. coli, S. aureus and K. pneumoniae. Most gram-negative bacteria were sensitive to Amikacin, gram positive bacteria were sensitive to multiple antibiotics.
Burns is a severe trauma that occurs in adult and pediatric patients, has several causative agents and can compromise the patient's life. The burned patient is at risk for a variety of infections. According to the type of infection it is possible to infer the most common causative organisms and their antibiotic sensitivity/resistance which allow a directed early empiric treatment.
在全球范围内，烧伤每年导致超过30万例死亡；感染是这些患者发病和死亡的主要原因。早期识别和治疗感染可改善预后。为此，有必要确定最常引发感染的医院菌群和微生物。
对在桑坦德大学医院（HUS）住院的烧伤患者所发生的感染进行特征描述。
对2014年1月1日至12月31日在HUS住院的烧伤患者进行随访。获取有关感染的医疗信息、实验室和病理报告。进行了集中趋势测量、比例、总体和特定发病率密度以及总体和特定发病率的统计分析。确定了微生物谱比例。
纳入402例烧伤患者，其中男性234例（58.2%），女性168例（41.8%），年龄在6天至83岁之间，中位数为12.5岁。烧伤原因包括烫伤（52.5%）、火灾（10.0%）、汽油烧伤（9.2%）、电击伤（7.5%）等。烧伤面积为1%至80%体表面积。累积死亡率为1.5%。27.8%的烧伤患者发生了一种或多种感染。已识别的感染包括毛囊炎（27.0%）、尿路感染（19.0%）、烧伤创面感染（10.4%）、肺炎（8.6%）、中心静脉导管相关感染（7.4%）、血流感染（7.4%）和皮肤移植感染（4.3%）等。88.5%的病例由细菌引起，11.5%由真菌引起。最常分离出的病菌为铜绿假单胞菌、鲍曼不动杆菌、大肠杆菌、金黄色葡萄球菌和肺炎克雷伯菌属。大多数革兰氏阴性菌对阿米卡星敏感，革兰氏阳性菌对多种抗生素敏感。
烧伤是一种发生在成人和儿童患者中的严重创伤，有多种致病因素，可危及患者生命。烧伤患者有发生多种感染的风险。根据感染类型，可以推断出最常见的致病微生物及其抗生素敏感性/耐药性，从而进行有针对性的早期经验性治疗。
