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烧伤创面分离微生物的分布及耐药特征:10 年回顾性分析。

The Distribution and the Antimicrobial Susceptibility Features of Microorganisms Isolated From the Burn Wounds: A 10-Year Retrospective Analysis.

机构信息

Department of Microbiology, Faculty of Medicine, Yüzüncü Yıl University, Van 65080, Turkey.

Department of Microbiology, Faculty of Medicine, Mardin Artuklu University, Mardin 47200, Turkey.

出版信息

J Burn Care Res. 2024 Mar 4;45(2):384-397. doi: 10.1093/jbcr/irad158.

Abstract

In this study, we aimed to evaluate the distribution features and antimicrobial susceptibility test results of the microorganisms isolated from the wounds of pediatric and adult patients with burn. The culture and susceptibility test results of the microorganisms, isolated from the wound swabs of the patients hospitalized in a tertiary-burn care center in 10-year period, were retrospectively screened on the microbiology department databases. Their distribution of isolated microorganisms regarding species and susceptibility test results were compared with previous studies. A total of 367 microorganisms, isolated from the burn wounds of 293 patients (13 ± 18.9 years, F/M: 0.93) (73 adults and 220 pediatric patients), were included in this study. A solitary agent was isolated in 239 (81.6%) patients, while 2 were isolated in 43 (14.7%) and 3 or more agents in 11 (3.8%). From these, 33% of the isolated microorganisms were gram-positive cocci, 61% were gram-negative bacteria, and 6% were Candida spp. The most common isolated microorganisms were Staphylococcus aureus (18.5%), Pseudomonas spp. (16.9%), and Escherichia coli (11.2%), while the least common was Streptococcus spp. (2.5%). Methicillin resistance was 15% among the S. aureus strains. No resistance was observed against levofloxacin, vancomycin, teicoplanin, linezolid, daptomycin, fusidic acid, and tigecycline in S. aureus strains. The highest resistance rates were observed against levofloxacin (64%), tobramycin (64%), pip/tazobactam (63%), imipenem (63%), and the lowest against colistin (5%) and ceftazidime (29%), among Pseudomonas spp. The most common causative agents in burn wound infections and their current antimicrobial susceptibility features should be well identified, in order for prevention of serious complications and optimal management the condition to occur.

摘要

在这项研究中,我们旨在评估从儿科和成人烧伤患者伤口中分离的微生物的分布特征和药敏试验结果。回顾性筛选了 10 年间在一家三级烧伤治疗中心住院的患者的伤口拭子培养和微生物药敏试验结果。将分离的微生物的物种分布及其药敏试验结果与以往的研究进行比较。共纳入 293 例(13±18.9 岁,F/M:0.93)烧伤患者(73 例成人和 220 例儿童)的 367 株微生物。239 例(81.6%)患者仅分离出一种病原体,43 例(14.7%)患者分离出 2 种病原体,11 例(3.8%)患者分离出 3 种或以上病原体。其中,33%的分离微生物为革兰阳性球菌,61%为革兰阴性菌,6%为念珠菌属。最常见的分离微生物为金黄色葡萄球菌(18.5%)、铜绿假单胞菌(16.9%)和大肠埃希菌(11.2%),最少的为链球菌属(2.5%)。金黄色葡萄球菌菌株中,耐甲氧西林的比例为 15%。金黄色葡萄球菌菌株对左氧氟沙星、万古霉素、替考拉宁、利奈唑胺、达托霉素、夫西地酸和替加环素均无耐药性。铜绿假单胞菌对左氧氟沙星(64%)、妥布霉素(64%)、哌拉西林/他唑巴坦(63%)、亚胺培南(63%)的耐药率最高,对黏菌素(5%)和头孢他啶(29%)的耐药率最低。明确烧伤创面感染的常见病原体及其目前的抗菌药物敏感性特征,对于预防严重并发症和优化治疗具有重要意义。

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