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万隆哈桑·萨迪金综合医院严重烧伤合并脓毒症患者的概况

The Profile Of Severe Burn Injury Patients With Sepsis In Hasan Sadikin Bandung General HospitaL.

作者信息

Soedjana H, Nadia J, Sundoro A, Hasibuan L, Rubianti I W, Putri A C, Septrina R, Riestiano B E, Prasetyo A T, Harianti S

机构信息

Faculty of Medicine Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.

出版信息

Ann Burns Fire Disasters. 2020 Dec 31;33(4):312-316.

Abstract

Burn injury remains a major global health issue. An estimated 180,000 people die annually due to burn injury, and most cases occur in low- and middle-income countries, including Indonesia. Several complications of burns may lead to mortality, and sepsis is one of the major threats, with the risk of developing multi organ dysfunction syndrome. This study applied a descriptive-retrospective method on 3-year medical records of severe burn injury patients. The data were classified according to age, etiology, outcome, antibiotic resistance, and pathogens of sepsis. There were 100 medical records of severe burn injury, and 55% of them were accompanied by sepsis. The highest number of sepsis cases was found in the age category of 40-50 years old. Nearly 80% of the cases were fire-related burns. Blood and burn wound culture of recovered patients showed 55% contamination with gram-positive bacteria, and 50% of them with Staphylococcus hominis. Contamination of blood and burn wound culture of deceased patients with gram-negative bacteria was 100%, 60% of them with Pseudomonas Aeruginosa. There is a more than 50% chance of severe burn patients falling into septic conditions. More than half of the patients were infected with gram-negative bacteria. Pseudomonas aeruginosa remains the main culprit of septic burn-related death.

摘要

烧伤仍是一个重大的全球健康问题。据估计,每年有18万人死于烧伤,大多数病例发生在低收入和中等收入国家,包括印度尼西亚。烧伤的几种并发症可能导致死亡,脓毒症是主要威胁之一,存在发展为多器官功能障碍综合征的风险。本研究对重度烧伤患者的3年病历采用描述性回顾性方法。数据根据年龄、病因、结局、抗生素耐药性和脓毒症病原体进行分类。有100份重度烧伤病历,其中55%伴有脓毒症。脓毒症病例数最多的年龄组为40 - 50岁。近80%的病例为与火灾相关的烧伤。康复患者的血液和烧伤创面培养显示55%被革兰氏阳性菌污染,其中50%被人葡萄球菌污染。死亡患者的血液和烧伤创面培养被革兰氏阴性菌污染的比例为100%,其中60%被铜绿假单胞菌污染。重度烧伤患者陷入脓毒症状态的可能性超过50%。超过一半的患者感染了革兰氏阴性菌。铜绿假单胞菌仍然是烧伤相关脓毒症死亡的主要元凶。

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