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中国东部一起 LPG 罐车爆炸导致的极严重烧伤的流行病学和早期细菌学研究。

Epidemiology and Early Bacteriology of Extremely Severe Burns from an LPG Tanker Explosion in Eastern China.

机构信息

Department of Burns and Wound Care Center, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China.

Key Laboratory of the Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, China.

出版信息

J Epidemiol Glob Health. 2022 Dec;12(4):478-485. doi: 10.1007/s44197-022-00066-0. Epub 2022 Sep 27.

Abstract

The incidence of liquefied petroleum gas (LPG)-related accidents in China has increased over the recent years. In addition, infection remains a big challenge in cases of severe burns. Therefore, the present study aimed to provide valuable information for a better control of infections in the event of such disasters. In this study, a total of 16 patients who suffered extremely severe burns after an LPG tanker explosion were included. Thereafter, bacteriological culture results were collected within a week. Of 16 patients, 13 (81.25%) were male and the average age of all patients was 60.63 years. In addition, the mean burned area was 83.03% TBSA. Additionally, a total of 553 organism cultures were conducted out of which 287 isolates (51.90%) showed positive results. Notably, 38.52% were Gram-negative bacteria, 7.59% were Gram-positive bacteria and 5.79% were fungi. Moreover, the most prevalent Gram-negative bacteria were Stenotrophomonas maltophilia (28.97%) followed by Acinetobacter baumannii (28.53%), and Klebsiella pneumoniae (14.02%). On the other hand, the three most predominant Gram-positive bacteria were Enterococcus faecalis (33.33%), Staphylococcus aureus (28.89%) and Staphylococcus sciuri (17.78%). Furthermore, the most common fungi included Candida (38.24%), Fusarium (20.59%) and Aspergillus fumigatus (14.71%). With regard to the bacterial resistance patterns, carbapenem-resistant organisms included Acinetobacter baumannii (97.80%), Pseudomonas aeruginosa (67.57%), and Klebsiella pneumoniae (75.56%). In addition, Staphylococcus sciuri, Staphylococcus epidermidis, and Staphylococcus haemolyticus were identified to be methicillin-resistant. This study revealed that there was a high incidence of infection in victims of severe burns as a result of mass burn accidents, accompanied by early fungal infection.

摘要

近年来,中国液化石油气(LPG)相关事故的发生率有所增加。此外,感染仍然是严重烧伤病例的一大挑战。因此,本研究旨在为更好地控制此类灾害中的感染提供有价值的信息。

在本研究中,共纳入了 16 名因 LPG 罐车爆炸而遭受极重度烧伤的患者。此后,在一周内收集了细菌学培养结果。16 名患者中,男性 13 例(81.25%),平均年龄为 60.63 岁。此外,所有患者的平均烧伤面积为 83.03%TBSA。此外,共进行了 553 次菌培养,其中 287 株(51.90%)培养结果阳性。值得注意的是,革兰氏阴性菌占 38.52%,革兰氏阳性菌占 7.59%,真菌占 5.79%。此外,最常见的革兰氏阴性菌是嗜麦芽寡养单胞菌(28.97%),其次是鲍曼不动杆菌(28.53%)和肺炎克雷伯菌(14.02%)。另一方面,三种最主要的革兰氏阳性菌是粪肠球菌(33.33%)、金黄色葡萄球菌(28.89%)和松鼠葡萄球菌(17.78%)。此外,最常见的真菌包括念珠菌(38.24%)、镰刀菌(20.59%)和烟曲霉(14.71%)。

关于细菌耐药模式,耐碳青霉烯类的病原体包括鲍曼不动杆菌(97.80%)、铜绿假单胞菌(67.57%)和肺炎克雷伯菌(75.56%)。此外,松鼠葡萄球菌、表皮葡萄球菌和溶血葡萄球菌被鉴定为耐甲氧西林。

本研究表明,大面积烧伤事故中严重烧伤患者感染发生率较高,且早期真菌感染。

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A Rare Case of Fungal Burn Wound Infection Caused by in Vietnam.越南一例罕见的 致真菌性烧伤创面感染
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