Stein A, Maurin M, Raoult D
Service de bactériologie, Hôpital de la Conception, Marseille.
Rev Prat. 1994 Sep 1;44(13):1786-91.
Infection of cutaneous wounds can be defined as proliferation of microorganisms at an interruption in the mucocutaneous covering. The phenomenon depends on an association of local and general factors which disturb the balance in host-pathogen interactions, in favor of the latter. In addition to infections by nonspecific pyogenic germs, whether posttraumatic or postsurgical, there are specific infections where the wound is the departure point for a systemic infection. Even today, tetanus and gaseous gangrene should be apprehended and systematically prevented. Similarly, the high incidence of infection of bite or scratch wounds (animal or human) should suggest prophylactic antibiotic treatment as well as evaluation of the risk of rabies in the case of animal bites or scratches. In any case, even if antibiotic treatment must be undertaken as an emergency measure, previous bacteriological investigation should be carried out if possible since it permits subsequent adaptation in case of failure of the initial antibiotic treatment.
皮肤伤口感染可定义为微生物在黏膜皮肤覆盖中断处的增殖。这种现象取决于局部和全身因素的共同作用,这些因素会干扰宿主与病原体相互作用的平衡,从而有利于病原体。除了非特异性化脓性细菌引起的感染(无论是创伤后还是手术后),还有一些特殊感染,伤口是全身感染的起始点。即使在今天,破伤风和气性坏疽仍应引起重视并进行系统预防。同样,咬伤或抓伤伤口(动物或人所致)感染的高发生率提示应进行预防性抗生素治疗,以及在动物咬伤或抓伤情况下评估狂犬病风险。无论如何,即使必须作为紧急措施进行抗生素治疗,如果可能的话,应事先进行细菌学检查,因为这在初始抗生素治疗失败时有助于后续调整治疗方案。