烧伤患者创面感染病原菌分布与多元危险因素回顾性研究  

Retrospective study on pathogenic bacteria distribution and multiple risk factors of wound infection in burn patients

作　　者：刘淑岩 段雪敬 赵宇辉 张泰海 LIU Shuyan;DUAN Xuejing;ZHAO Yuhui;ZHANG Taihai(Burn and Plastic Surgery Department 1 Tangshan Workers Hospital,Tangshan063000,Hebei,China)

机构地区：[1]唐山市工人医院烧伤整形一科,河北唐山063000

出　　处：《中国病原生物学杂志》2024年第12期1474-1477,1482,共5页Journal of Pathogen Biology

基　　金：河北省科技成果推广课题项目(No.20211358)。

摘　　要：目的探讨烧伤患者创面感染病原菌分布与多元危险因素回顾性研究。方法选取2020年1月至2024年2月于本院诊治的189例烧伤患者作为研究对象,根据是否出现创面感染分为感染组(n=63)和非感染组(n=126),观察感染组病原菌分布特征,Logistic回归分析影响肠外瘘患者并发腹腔感染的危险因素,并依据危险因素构建预测烧伤患者并发创面感染的综合指数;绘制受试者工作特征(ROC)曲线分析危险因素及综合指数预测烧伤患者并发创面感染的AUC、敏感度及特异度。结果63例烧伤伴创面感染患者经病原菌培养分离出87株病原菌,其中革兰阳性菌33株(37.93%),革兰阴性菌54株(62.07%)。感染组与非感染组在性别、年龄、吸烟史、饮酒史、高血压史、烧伤原因、烧伤部位、住院时间、创面置管等资料比较,差异无统计学意义(P>0.05);而在糖尿病史、烧伤面积、烧伤深度、吸入性损伤、ICU停留时间等资料比较中,差异有统计学意义(P<0.05)。Logistic回归分析显示,糖尿病史、烧伤面积≥40%、烧伤Ⅲ度、吸入性损伤、ICU停留时间>7d是影响烧伤患者并发创面感染的危险因素(P<0.05)。ROC曲线分析显示,糖尿病史、烧伤面积、烧伤深度、吸入性损伤、ICU停留时间及综合指数预测烧伤患者并发创面感染的AUC分别为(0.627、0.631、0.587、0.607、0.599、0.761)。敏感度分别为49.20%、66.70%、46.00%、46.00%、44.40%、69.80%;特异度分别为76.20%、59.50%、71.40%、75.40%、75.40%、73.00%。综合指数的AUC值分别与糖尿病史、烧伤面积、烧伤深度、吸入性损伤、ICU停留时间比较,差异有统计学意义(P<0.05)。结论烧伤患者并发创面感染以金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌、大肠埃希菌多见,且糖尿病史、烧伤面积、烧伤深度、吸入性损伤、ICU停留时间会对患者并发创面感染产生影响。Objective To investigate the distribution of pathogenic bacteria and multiple risk factors of wound infection in burn patients.Methods A total of 189 burn patients diagnosed and treated in our hospital from January 2020 to February 2024 were selected as research objects,and divided into infected group(n=63)and non-infected group(n=126)according to whether or not they had wound infection.The distribution characteristics of pathogenic bacteria in the infected group were observed,and the risk factors affecting patients with intestinal fistula complicated with abdominal infection were analyzed by Logistic regression.Based on risk factors,a comprehensive index was constructed to predict wound infection in burn patients.Receiver operating characteristic(ROC)curve was drawn to analyze risk factors and composite index to predict AUC,sensitivity and specificity of burn patients complicated with wound infection.Results 87 strains of pathogens were isolated from 63 burn patients with wound infection,of which 33(37.93%)were grampositive and 54(62.07%)were gram-negative.There was no significant difference in gender,age,smoking history,drinking history,hypertension history,burn cause,burn site,hospital stay and wound catheterization between infected group and non-infected group(P>0.05).There were significant differences in diabetes history,burn area,burn depth,inhalation injury and ICU stay time(P<0.05).Logistic regression analysis showed that diabetes history,burn area≥40%,burn II degree,inhalation injury,ICU stay>7 days were the risk factors for burn patients complicated with wound infection(P<0.05).ROC curve analysis showed that the AUC of diabetes history,burn area,burn depth,inhalation injury,ICU stay time and composite index predicting wound infection in burn patients were 0.627,0.631,0.587,0.607,0.599,0.761,respectively.Sensitivity was 49.20%,66.70%,46.00%,46.00%,44.40%,69.80%.The specificity was 76.20%,59.50%,71.40%,75.40%,75.40%and 73.00%.The AUC value of the composite index was statistically significant compared wi

关 键 词：烧伤 创面感染 病原菌 危险因素 

分 类 号：R644[医药卫生—外科学] R446.5[医药卫生—临床医学]