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五年期间烧伤患者细菌感染的流行病学概况

Epidemiological Profile of Bacterial Infections in Burn Patients Over a Five-Year Period.

作者信息

Ibrahim Youssouf Ahmed, Benaissa Elmostafa, Belouad El Mehdi, Malihy Zakaria, Benlahlou Yassin, Maleb Adil, Chadli Mariama, Elouennass Mostafa

机构信息

Bacteriology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V Military Training Hospital, Mohammed V University, Rabat, MAR.

出版信息

Cureus. 2024 Nov 30;16(11):e74848. doi: 10.7759/cureus.74848. eCollection 2024 Nov.

Abstract

INTRODUCTION

Burn patients are highly susceptible to bacterial infections, which significantly increase morbidity and mortality. Destruction of skin barriers following burns creates an ideal environment for tissue colonization by pathogenic microorganisms.

OBJECTIVES

The aim of our study is to establish the epidemiological profile of bacterial infections in burn patients hospitalized in the Burns and Plastic Surgery Department of the Mohamed V Military Teaching Hospital (HMIMV) in Rabat and to describe their sensitivity to antibiotics.

MATERIALS AND METHODS

This retrospective study spanned five years, from October 1, 2017, to December 31, 2022. During this period, a total of 548 samples were obtained, of which 366 (66.78%) were positive, corresponding to isolates of 39 non-redundant bacterial strains identified in 188 patient samples. Among these patients, 123 (65.42%) were males and 65 (34.22%) were females, yielding a sex ratio of 1.89. The mean age of the patients was 47.1 years, with an age range of 9 to 89 years. Microbiological and demographic data were collected for analysis. Bacterial isolates were identified using conventional bacteriological methods, and their antibiotic susceptibility was tested according to EUCAST 2019 guidelines.

RESULTS

Of 548 samples, 406 (74.08%) skin burns, 74 (13.5%) blood cultures, 29 (5.29%) urine samples, and 27 (4.92%) central catheter samples were analyzed. Among the gram-negative, non-fermenting bacilli (GNB) bacilli, (n=92; 16.78%) were in the majority, with accounting for 85 (92.39%) cases, while represented 78 (14.23%) cases, including 74 (94.87%) of . Gram-positive bacteria were dominated by (n=123; 22.44%), including (n=60; 49.18%) and coagulase-negative (n=63; 51.63%). Antibiotic resistance rates were particularly high among gram-negative bacteria, with resistance to carbapenems and cephalosporins being particularly alarming in . Among gram-positive cocci, strains of showed moderate resistance to several antibiotics but remained susceptible to glycopeptides.

CONCLUSION

Non-fermentable gram-negative bacilli, particularly and species, are widespread in burn patients and show worrying levels of resistance to many antibiotics. These results underline the importance of judicious antibiotic management and rigorous infection control practices in burn care units.

摘要

引言

烧伤患者极易发生细菌感染,这显著增加了发病率和死亡率。烧伤后皮肤屏障的破坏为致病微生物在组织中定植创造了理想环境。

目的

我们研究的目的是确定拉巴特穆罕默德五世军事教学医院(HMIMV)烧伤整形科住院烧伤患者细菌感染的流行病学特征,并描述其对抗生素的敏感性。

材料与方法

这项回顾性研究跨越五年,从2017年10月1日至2022年12月31日。在此期间,共获取了548份样本,其中366份(66.78%)呈阳性,对应于在188例患者样本中鉴定出的39种非冗余细菌菌株的分离株。在这些患者中,男性123例(65.42%),女性65例(34.22%),性别比为1.89。患者的平均年龄为47.1岁,年龄范围为9至89岁。收集微生物学和人口统计学数据进行分析。使用传统细菌学方法鉴定细菌分离株,并根据2019年欧洲药敏试验委员会(EUCAST)指南测试其抗生素敏感性。

结果

在548份样本中,分析了406份(74.08%)皮肤烧伤样本、74份(13.5%)血培养样本、29份(5.29%)尿液样本和27份(4.92%)中心导管样本。在革兰氏阴性非发酵杆菌(GNB)中,鲍曼不动杆菌(n = 92;16.78%)占多数,其中醋酸钙不动杆菌占85例(92.39%),而嗜麦芽窄食单胞菌占78例(14.2%),其中嗜麦芽窄食单胞菌占74例(94.87%)。革兰氏阳性菌以金黄色葡萄球菌(n = 123;22.44%)为主,包括耐甲氧西林金黄色葡萄球菌(n = 60;49.18%)和凝固酶阴性葡萄球菌(n = 63;51.63%)。革兰氏阴性菌中的抗生素耐药率特别高,鲍曼不动杆菌对碳青霉烯类和头孢菌素类的耐药性尤其令人担忧。在革兰氏阳性球菌中,金黄色葡萄球菌菌株对几种抗生素表现出中度耐药,但对糖肽类仍敏感。

结论

不可发酵革兰氏阴性杆菌,尤其是鲍曼不动杆菌和嗜麦芽窄食单胞菌,在烧伤患者中广泛存在,且对多种抗生素的耐药水平令人担忧。这些结果强调了在烧伤护理病房中合理使用抗生素管理和严格感染控制措施的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4750/11685545/7c6f844bbf36/cureus-0016-00000074848-i01.jpg

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