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中亚炎热气候下的冻伤:伤口微生物群及抗生素治疗的回顾性分析

Frostbite in hot climates of Central Asia: retrospective analysis of the microflora of wound and antibiotic therapy.

作者信息

Shakirov Babur M

机构信息

Samarkand Medical Institute Samarkand, Uzbekistan.

Burn Department of The Centre of Emergency Medical Care Samarkand, Uzbekistan.

出版信息

Int J Burns Trauma. 2022 Jun 15;12(3):93-97. eCollection 2022.

Abstract

The problem of deep frostbites belongs to one of the most complex in surgery. Treatment of such victims is very prolonged, expensive, requiring crippling operations resulting in disability. The purpose of this present study is of etiological structure of the wound microflora and its tolerance to antibacterial preparations in patients with cold injury in the regions with warm climate of severe degree. 57 microbiological investigations of wound secretions in 38 patients with severe cold injury treated in our Burn Department of RSCUMA, Samarkand, Uzbekistan had been carried out. Microflora of wounds in patients who suffered from cold injury is characterized by polyetiology and is presented by gramnegative (49.5%) and grampositive (50.5%) microorganisms. There are Pseudomonas aeruginosa (17.9%). Among gramnegative microorganisms. In this context sensitivity to preparations owing activity to Pseudomonas aeruginosa-Ceftazidim, Ceferin and Amycacin makes 48.8%, 54.5% and 81.3% accordingly. Prevailing flora of grampositive is Staphylococcus aureus (26.3% of agents), of which 60% makes MRSA. High resistance to Ciprofloxacin (66.6%), Erythromycin (52.5%) and Lincomycin (44.4%) is noted. The investigations give evidence that ABT in patient with severe frostbites is a serious problem and needs well-ground approach in prescribing antibacterial preparations.

摘要

深度冻伤问题属于外科领域最复杂的问题之一。治疗这类患者的过程非常漫长且费用高昂,需要进行致残性手术,最终导致残疾。本研究的目的是探讨在气候温暖但严寒程度较高地区,冷损伤患者伤口微生物群的病因结构及其对抗菌制剂的耐受性。我们对乌兹别克斯坦撒马尔罕市俄罗斯撒马尔罕临床大学附属医院烧伤科收治的38例严重冷损伤患者的伤口分泌物进行了57次微生物学调查。冷损伤患者伤口的微生物群具有多病因特点,由革兰氏阴性菌(49.5%)和革兰氏阳性菌(50.5%)组成。其中铜绿假单胞菌占17.9%,在革兰氏阴性微生物中。在这种情况下,对因铜绿假单胞菌活性而对制剂敏感的头孢他啶、头孢呋辛和丁胺卡那霉素的敏感性分别为48.8%、54.5%和81.3%。革兰氏阳性菌的主要菌群是金黄色葡萄球菌(占菌株的26.3%),其中60%为耐甲氧西林金黄色葡萄球菌。注意到对环丙沙星(66.6%)、红霉素(52.5%)和林可霉素(44.4%)的高耐药性。调查表明,严重冻伤患者的抗菌治疗是一个严重问题,在开具抗菌制剂时需要有充分依据的方法。

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Frostbite: a practical approach to hospital management.冻伤:医院管理的实用方法
Extrem Physiol Med. 2014 Apr 22;3:7. doi: 10.1186/2046-7648-3-7. eCollection 2014.
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Frostbite: prevention and initial management.冻伤:预防和初步处理。
High Alt Med Biol. 2013 Mar;14(1):9-12. doi: 10.1089/ham.2012.1114.
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Recognition and treatment of freezing and nonfreezing cold injuries.冻伤和非冻伤的识别与治疗。
Curr Sports Med Rep. 2013 Mar-Apr;12(2):125-30. doi: 10.1249/JSR.0b013e3182877454.
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A history of frostbite treatment.冻伤治疗史。
Int J Circumpolar Health. 2000 Apr;59(2):99-107.

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