老年烧伤患者医院感染情况及其相关因素分析  

Nosocomial infection and its related factors in elderly burn patients

作　　者：李晓梅[1] 李玉洁[1] 

机构地区：[1]宝鸡市中心医院整形烧伤科,陕西宝鸡721008

出　　处：《西部医学》2016年第11期1587-1590,共4页Medical Journal of West China

摘　　要：目的通过对老年烧伤患者医院感染状况及其相关因素分析,为开展老年烧伤患者创口感染防控提供理论支持。方法采用细菌分离鉴定技术和药敏试验方法,对137例老年烧伤患者创面分泌物的病原菌进行菌株分离培养+药敏实验,并分析结果。结果 137例老年烧伤患者创面感染者67例(48.91%);培养出病原菌53株,其中革兰阳性菌12株(22.64%),革兰阴性菌40株(75.47%),真菌1株(1.89%)。前3位致病菌分别为铜绿假单胞菌(24.53%)、金黄色葡萄球菌(18.87%)和大肠埃希菌(15.09%);金黄色葡萄菌对万古霉素、对庆大霉素和利福平敏感性高。铜绿假单胞菌对多粘菌素B和头孢西丁敏感,大肠埃希菌对多粘菌素B敏感;就医时间>12小时,创口感染率显著高于12内就医者(P<0.05);之前偶尔使用抗生素者感染率为24.32%,低于经常使用抗生素者(59.79%),两者间有统计学意义(P<0.05)。结论老年烧伤患者创口感染的致病菌种类复杂,以铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌为主,病原菌对常用抗菌药物的敏感性较低。临床治疗中应认真做好细菌药敏试验,加强耐药性监测,合理选择抗菌药物,提高烧伤患者创口感染防控质量。Objective To provide theoretical support for the development elderly burn patients wound infection prevention and control by infection and related factors in elderly patients in hospital burn analysis,. Methods 137 elderly patients with burn wound were enrolled in the present study. The pathogens were isolated from the wound secretions and detected their drug sensitivity. Results There were 67 patients （48.91% ） with infection of 137 elderly burn patients and 53 pathogens were isolated. 12 （22.64 %） pathogens were Gram-positive bacteria, 40 （75.47 %） pathogens were Gramnegative bacteria and 1 （1.89%） pathogen were fungi. The top three pathogens were Pseudomonas aeruginosa （24.53%）, Staphylococcus aureus （18.87%） and Escherichia coli （15.09%）. Staphylococcus aureus was sensitive to vancomycin, gentamicin and rifampicin. Pseudomonas aeruginosa was sensitive to poiymyxin B and cefoxitin. Escherichia coli was sensitive to polymyxin B. The wound infection rate was significantly higher than in the 12 medical treatment （P〈 0.05） . The occasional use of antibiotics infection rate was 24.32%, significantly lower than the commonly used antibiotics （59. 79%） （P〈0.05）. Conclusion The pathogens of elderly patients with burn wound infection are complicated. Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli were common pathogens. The pathogens are not sensitive to common drugs. The antimicrobial susceptibility test, monitoring of drug resistance and reasonable choice of antibiotics can improve patient burn wound infection prevention and control quality.

关 键 词：老年烧伤 病原菌 敏感性 抗菌药物 

分 类 号：R644[医药卫生—外科学]