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医疗保健相关烧伤创面感染患者中多重耐药菌的危险因素及分布情况

Risk factors and distribution of MDROs among patients with healthcare associated burn wound infection.

作者信息

ALfadli Mariam, El-Sehsah Eman M, Ramadan Moustapha Ahmed-Maher

机构信息

PhD, Director of Infection Control Directorate, Ministry of Health, Sabbah health region, P.O.Box: 12414 Alshamiya, Kuwait.

PhD, Lecturer at Microbiology and Immunology Department, Faculty of medicine, Mansoura University, Egypt, Specialist of Infection Control at Infection Control Directorate, Ministry of Health, Sabbah health region, P.O.Box: 12414 Alshamiya, Kuwait.

出版信息

Germs. 2018 Dec 3;8(4):199-206. doi: 10.18683/germs.2018.1147. eCollection 2018 Dec.

Abstract

INTRODUCTION

Patients with burn wounds are more susceptible to develop healthcare associated (HA) infection. Bacterial isolates from HA burn wound infection vary from one place to the other and also differ in terms of antimicrobial susceptibility pattern. The aim of our study was to assess the incidence of HA burn wound infection, risk factors and to determine the microbiological profile and antimicrobial susceptibility pattern of isolated pathogens.

METHODS

This was a one-year retrospective descriptive study conducted between January 2017 and December 2017, in Al-Babtain Burn and Plastic Surgery center, Kuwait. The identification of bacterial isolates was conducted by conventional biochemical methods according to standard microbiological techniques and commercially available kits using analytical profile index procedure.

RESULTS

Total body surface area >35% affected and length of stay more than 14 days were statistically significant risk factors for HA burn infection (RR of 10.057 and 5.912, respectively). Analysis of microbiological profile of these positive cultures indicated that the most common isolated organism was followed by . Multidrug resistant organisms composed 65.85% of the positive isolates. Vancomycin, tigecycline, teicoplanin and linezolid showed 100% effectiveness for all Gram positive isolates. For Gram negative organisms, imipenem and meropenem showed 38.71% and 41.93% efficacy, respectively.

CONCLUSION

Identification of antimicrobial susceptibility patterns helps to tailor the required antibiotic policy to minimize the acquired infections among these vulnerable patients.

摘要

引言

烧伤患者更容易发生医疗相关(HA)感染。不同地区HA烧伤创面感染分离出的细菌不同,其药敏模式也存在差异。我们研究的目的是评估HA烧伤创面感染的发生率、危险因素,并确定分离病原体的微生物学特征和药敏模式。

方法

这是一项为期一年的回顾性描述性研究,于2017年1月至2017年12月在科威特的Al-Babtain烧伤整形中心进行。根据标准微生物技术和使用分析谱指数程序的商用试剂盒,通过传统生化方法对细菌分离株进行鉴定。

结果

全身表面积受累>35%和住院时间超过14天是HA烧伤感染的统计学显著危险因素(相对风险分别为10.057和5.912)。对这些阳性培养物的微生物学特征分析表明,最常见的分离菌是 ,其次是 。多重耐药菌占阳性分离株的65.85%。万古霉素、替加环素、替考拉宁和利奈唑胺对所有革兰氏阳性分离株均显示100%的有效性。对于革兰氏阴性菌,亚胺培南和美罗培南的有效率分别为38.71%和41.93%。

结论

确定药敏模式有助于制定所需的抗生素策略,以尽量减少这些易感患者的获得性感染。

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