Costescu Strachinaru Diana Isabela, Gallez Jean-Luc, François Pierre-Michel, Baekelandt Dries, Paridaens Marie-Sophie, Pirnay Jean-Paul, De Vos Daniel, Djebara Sarah, Vanbrabant Peter, Strachinaru Mihai, Soentjens Patrick
Center for Infectious Diseases, Queen Astrid Military Hospital, Brussels, Belgium.
Microbiology Laboratory, Queen Astrid Military Hospital, Brussels, Belgium.
Acta Clin Belg. 2022 Apr;77(2):353-359. doi: 10.1080/17843286.2021.1872309. Epub 2021 Jan 12.
Infections are a major cause of morbidity in burn patients. We aimed to investigate the epidemiology and antibiotic susceptibility of blood stream infections in order to gain a better understanding of their role and burden in our Burn Wound Center.
This retrospective epidemiological investigation analyzed data derived from medical files of patients admitted to our Burn Wound Center having had at least one positive blood culture between 1 January and 31 December 2018. We focused on the prevalence of causative agents in blood stream infections in function of the time after injury and on their drug sensitivity.
Among the 363 patients admitted to our Burn Wound Center during the study period, 29 had at least one episode of blood stream infection. Gram-negative organisms accounted for 56,36% of the pathogens in blood stream infections, Gram-positives for 38,17%, and yeasts for 5,45%. was the most common bacterium (20%), followed by (16.36%), and (9,09% each). A third of the Gram-negative isolates were multidrug resistant. Gram-positive cocci were isolated from blood cultures at a median of 9 days after the injury, earlier than Gram-negative rods (median 15 days). The main sources of blood stream infections were the burn wounds, followed by infected catheters.
Multidrug resistant bacteria must be considered when selecting empirical antibiotic therapy in septic burn patients. In our center, we need to update our antibiotic guidelines, to review the hospital infection control measures and to introduce routine typing technology.
感染是烧伤患者发病的主要原因。我们旨在调查血流感染的流行病学和抗生素敏感性，以便更好地了解其在我们烧伤创面中心的作用和负担。
这项回顾性流行病学调查分析了2018年1月1日至12月31日期间入住我们烧伤创面中心且至少有一次血培养呈阳性的患者病历数据。我们重点关注血流感染病原体的患病率与受伤时间的关系及其药敏情况。
在研究期间入住我们烧伤创面中心的363例患者中，29例至少有一次血流感染发作。革兰氏阴性菌占血流感染病原体的56.36%，革兰氏阳性菌占38.17%，酵母菌占5.45%。 是最常见的细菌（20%），其次是 （16.36%）， 和 （各占9.09%）。三分之一的革兰氏阴性分离株对多种药物耐药。革兰氏阳性球菌在受伤后中位9天从血培养中分离出来，早于革兰氏阴性杆菌（中位15天）。血流感染的主要来源是烧伤创面，其次是感染的导管。
在选择脓毒症烧伤患者的经验性抗生素治疗时，必须考虑多重耐药菌。在我们中心，我们需要更新抗生素指南，审查医院感染控制措施并引入常规分型技术。
