Department of Emergency, People's Hospital of Rizhao, Jining Medical University, Shandong, China.
Department of Anesthesiology, People's Hospital of Rizhao, Jining Medical University, Shandong, China.
Medicine (Baltimore). 2022 Jul 29;101(30):e29943. doi: 10.1097/MD.0000000000029943.
The infection rate is high in patients injured at sea, and because of the unique distribution of marine microorganisms, the infection is often not easily controlled effectively with the empirical application of antibiotics. This study aims to consider the clinical characteristics and pathogen infection and drug susceptibility of patients injured at sea. From 2019 to 2021, there were 635 patients injured at sea in Rizhao People's Hospital. We assess the patient's basic condition, while performing bacterial culture and drug susceptibility testing on wound exudate or pus from infected patients. Among the 635 patients injured at sea, 195 people were infected, and the infection rate was 30.71%. Infected patients are usually older, have longer prehospital visits, and have lower normal levels of red blood cells, hemoglobin, total protein, and albumin. The causes of injury in infected patients were mainly avulsion and puncture injuries, and the types of injuries were mainly bone fracture, vascular injury, and nerve injury. A total of 305 strains of pathogenic bacteria were cultured in 195 patients. Gram-negative bacteria accounted for 77.05% (235 strains), of which Proteus was the most. Gram-positive bacteria accounted for 22.95% (70 strains), of which Staphylococcus aureus was the most. Gram-negative bacilli were sensitive to aminoglycosides, lactam antibiotics, carbapenems antibiotics, sulfonamides, quinolones, fourth-generation cephalosporins, and antibacterial drugs containing enzyme inhibitors, while most of the bacteria were resistant to penicillins, first-generation cephalosporins, and second-generation cephalosporins. Gram-positive bacteria were sensitive to quinuptin/dafoptin, rifampicin, linezolid, gentamicin, tigacycline, and vancomycin but resistant to penicillin antibiotics. Due to the particularity of marine injuries, patients are prone to infection. Pathogen culture and drug sensitivity analysis play an important role in guiding antiinfective treatment for marine injured patients.
海员受伤患者的感染率较高，且由于海洋微生物的独特分布，经验性应用抗生素往往难以有效控制感染。本研究旨在探讨海员受伤患者的临床特征及病原菌感染与药敏情况。选取 2019 年至 2021 年在日照市人民医院就诊的海员受伤患者 635 例，评估患者基本情况，对感染患者的伤口渗出液或脓液进行细菌培养和药敏试验。635 例海员受伤患者中 195 例发生感染，感染率为 30.71%。感染患者年龄较大，院前就诊时间较长，且红细胞、血红蛋白、总蛋白和白蛋白的正常水平较低。感染患者的致伤原因主要为撕脱伤和刺伤，损伤类型主要为骨折、血管损伤和神经损伤。195 例感染患者共培养出病原菌 305 株，其中革兰阴性菌占 77.05%（235 株），以变形杆菌属最为多见；革兰阳性菌占 22.95%（70 株），以金黄色葡萄球菌最为多见。革兰阴性杆菌对氨基糖苷类、β-内酰胺类抗生素、碳青霉烯类抗生素、磺胺类、喹诺酮类、四代头孢菌素及含酶抑制剂的抗菌药物较敏感，多数细菌对青霉素类、头孢一代和头孢二代较耐药；革兰阳性球菌对喹努普汀/达福普汀、利福平、利奈唑胺、庆大霉素、替加环素、万古霉素较敏感，对青霉素类抗生素耐药。由于海洋伤的特殊性，患者易发生感染，病原菌培养及药敏分析对指导海洋伤患者抗感染治疗具有重要意义。
