Bariar L M, Vasenwala S M, Malik A, Ansari G H, Chowdhury T E
JN Medical College, AMU, Aligarh.
J Indian Med Assoc. 1997 Nov;95(11):573-5.
Thirty-four patients with burns were subjected to the clinicopathological study with special reference to culture of the wound and histological examination of the burned tissue. The commonest cause of burn was thermal burn (91.18%) followed by electric burn (5.88%) and chemical burn (2.94%). The maximum number of patients belonged to second and third decades of life (61.78%). Females were commonest victims, with male:female ratio was 1:1.6. On the 1st to 3rd postburn day (PBD) most of the wound remained sterile and Strept haemolyticus was first bacteria isolated on 1st PBD. Gram-positive and Gram-negative bacteria, specially pseudomonas, invaded the burn wound as early as 3rd PBD, it was more so with the patients of extensive burn. Among the Gram-positive bacteria Staph aureus was most notorious and invaded burn wound very early. Pseudomonas had maximum growth followed by klebsiella and Esch coli, multidrug resistance was more common with pseudomonas. Among the fungal infections Candida albicans had maximum incidence. Positive blood cultures for bacteria were seen during 2nd, 3rd and 4th postburn weeks. Pseudomonas was the commonest bacteria isolated. Biopsies were done in 17 patients and showed maximum incidence of bacterial infection followed by fungal infection. Patients with burn more than 60% of total body surface area (TBSA) had 100% mortality, while patients with 20-30% of TBSA burn had 20% mortality, the overall mortality was 50%. Biopsies of the burn wound played an important role in the accurate diagnosis and thus helped in starting early specific therapy to prevent death from sepsis.
对34例烧伤患者进行了临床病理研究，特别关注伤口培养和烧伤组织的组织学检查。烧伤最常见的原因是热烧伤（91.18%），其次是电烧伤（5.88%）和化学烧伤（2.94%）。患者人数最多的年龄段为第二和第三个十年（61.78%）。女性是最常见的受害者，男女比例为1:1.6。在烧伤后第1至3天（PBD），大多数伤口保持无菌状态，溶血性链球菌是在第1个PBD首次分离出的细菌。革兰氏阳性菌和革兰氏阴性菌，特别是假单胞菌，早在第3个PBD就侵入烧伤伤口，大面积烧伤患者更是如此。在革兰氏阳性菌中，金黄色葡萄球菌最为臭名昭著，很早就侵入烧伤伤口。假单胞菌生长最多，其次是克雷伯菌和大肠杆菌，假单胞菌的多重耐药性更为常见。在真菌感染中，白色念珠菌的发病率最高。在烧伤后第2、3和4周出现了细菌血培养阳性。假单胞菌是最常见的分离细菌。对17例患者进行了活检，结果显示细菌感染的发生率最高，其次是真菌感染。烧伤面积超过全身表面积（TBSA）60%的患者死亡率为100%，而烧伤面积为20-30%TBSA的患者死亡率为20%，总体死亡率为50%。烧伤伤口的活检在准确诊断中起重要作用，从而有助于尽早开始特异性治疗以预防败血症死亡。
