Zhou Siqi, Xiao Shuzhen, Wang Xuedong, Wang Xuefeng, Han Lizhong
Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Antibiotics (Basel). 2023 Sep 11;12(9):1432. doi: 10.3390/antibiotics12091432.
Infection is the predominant contributor to morbidity and mortality in burn patients, and burn wound infection (BWI) is the most common reason. The objective of this research was to analyze the incidence, factors and progression of BWI, in terms of events and bacteria.
Clinical variables of all qualified patients admitted to burn wards were analyzed retrospectively in 2021 at a tertiary hospital in eastern China through univariate analysis and multivariate logistic regression. The Kaplan-Meier method was also used for plotting survival curves. Isolates and resistance data were evaluated to demonstrate the evolution of targeted antibiotics of strains from BWI.
A total of 580 (median age, 39.5 years (23-56 years); 372/580 (64.14%) male) patients were evaluated, 348 (60.0%) of whom experienced BWI. A variety of factors are associated with BWI. Multivariate logistic regression analysis showed that depth and area of burn and duration from burn to first hospitalization are independent risk factors for BWI. For BWI onset in these patients, 47.24% (274/580) occurred in the first week. The most frequently isolated causative organism was (15.7%) in patients with BWI. The duration of transition from Gram-positive strains (median 3 days, (2-7 days)) to Gram-negative (median 10 days, (4-17 days)) ones isolated from burn wound shrunk. Hospital length of stay was considered as a protective factor for BWI.
The precise assessment of factors affecting BWI in burn patients enhances prompt and suitable management. Swab cultures for surveillance could be utilized to monitor the microbiological status of burn patients.
感染是烧伤患者发病和死亡的主要原因，而烧伤创面感染（BWI）是最常见的原因。本研究的目的是从事件和细菌方面分析BWI的发生率、影响因素及进展情况。
2021年，在中国东部一家三级医院对所有入住烧伤病房的合格患者的临床变量进行回顾性分析，采用单因素分析和多因素逻辑回归分析。还采用Kaplan-Meier法绘制生存曲线。对分离株和耐药数据进行评估，以展示BWI菌株靶向抗生素的演变情况。
共评估了580例患者（中位年龄39.5岁（23 - 56岁）；372/580（64.14%）为男性），其中348例（60.0%）发生了BWI。多种因素与BWI相关。多因素逻辑回归分析显示，烧伤深度和面积以及从烧伤到首次住院的时间是BWI 的独立危险因素。在这些患者中，47.24%（274/580）的BWI发生在第一周。BWI患者中最常分离出的病原体是[具体病原体未给出]（15.7%）。从烧伤创面分离出的革兰氏阳性菌株（中位时间3天，（2 - 7天））向革兰氏阴性菌株（中位时间10天，（4 - 17天））转变的持续时间缩短。住院时间被认为是BWI的一个保护因素。
对烧伤患者影响BWI的因素进行精确评估有助于及时、合理的管理。可利用拭子培养进行监测，以监测烧伤患者的微生物状况。
