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加纳阿克拉一家三级教学医院烧伤创面患者的细菌感染情况。

Bacterial infections in burn wound patients at a tertiary teaching hospital in Accra, Ghana.

作者信息

Forson O A, Ayanka E, Olu-Taiwo M, Pappoe-Ashong P J, Ayeh-Kumi P J

机构信息

Department of Medical Laboratory Science, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.

Department of Medical Microbiology, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Legon, Accra, Ghana.

出版信息

Ann Burns Fire Disasters. 2017 Jun 30;30(2):116-120.

Abstract

Intact human skin surface is essential for protection against infection, preservation of body fluid homeostasis and thermoregulation. Burn injury compromises the skin barrier and enables bacterial infection, hence delaying burn wound healing. This study aimed to determine the microbial profile of burn wounds, and resistance patterns of microbes with respect to the source of the injured patient's wound. Fifty wound swab samples were collected from fifty burn patients at the Korle-Bu Teaching Hospital, Accra (KBTH). Sterile swabs moistened with sterile saline were used to swab burn wounds. The swabs were plated on blood agar and MacConkey agar for 24 hrs at 37°C. Biochemical tests were carried out on the representative isolate on each plate, and antibacterial sensitivity pattern was determined using the Kirby-Bauer disc diffusion method. The study revealed that the main source of burns was gas flames (66%) and scalds (28%). Out of the 50 samples analysed, 86% were culture positive and 14% were culture negative for bacteria. The predominant organisms isolated were Pseudomonas sp. (30.2%) and Acinetobacter sp. (20.9%). Proteus mirabillis (2.3%) and Staphylococcus aureus (2.3%) were the least frequently isolated bacteria. Although Pseudomonas sp. showed varying resistance levels to gentamicin, cotrimoxazole and ciprofloxacin, all the Acinetobacter sp. were resistant to most of the tested antibiotics used. Resistant gram negative bacteria are the most common isolates associated with burn wounds in Accra, Ghana. Hence a careful selection of antibiotics to control the wound infection is required for proper management of burn wounds in order to help reduce morbidity and mortality.

摘要

完整的人体皮肤表面对于预防感染、维持体液平衡和体温调节至关重要。烧伤会损害皮肤屏障,导致细菌感染,从而延缓烧伤创面愈合。本研究旨在确定烧伤创面的微生物谱,以及微生物相对于受伤患者创面来源的耐药模式。从阿克拉科勒-布教学医院(KBTH)的50名烧伤患者身上采集了50份伤口拭子样本。用无菌盐水浸湿的无菌拭子用于擦拭烧伤创面。将拭子接种在血琼脂和麦康凯琼脂上,于37°C培养24小时。对每个平板上的代表性分离株进行生化试验,并使用 Kirby-Bauer 纸片扩散法测定抗菌敏感性模式。研究表明,烧伤的主要来源是煤气火焰(66%)和烫伤(28%)。在分析的50个样本中,86%的样本细菌培养呈阳性,14%呈阴性。分离出的主要微生物是假单胞菌属(30.2%)和不动杆菌属(20.9%)。奇异变形杆菌(2.3%)和金黄色葡萄球菌(2.3%)是分离频率最低的细菌。虽然假单胞菌属对庆大霉素、复方新诺明和环丙沙星表现出不同程度的耐药性,但所有不动杆菌属对大多数测试抗生素均耐药。耐革兰氏阴性菌是加纳阿克拉烧伤创面最常见的分离菌。因此,为了妥善处理烧伤创面以帮助降低发病率和死亡率,需要谨慎选择抗生素来控制伤口感染。

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