烧伤患者创面感染的病原学特点及影响因素分析  

Pathogen Characteristics and Risk Factors of Wound Infection in Burn Patients

作　　者：朱春梅 向天新[1] 郭华明 万娟[2] 魏春萍 魏丹丹[3] ZHU Chunmei;XIANG Tianxin;GUO Huaming;WAN Juan;WEI Chunping;WEI Dandan(Infection Control Center,The First Affiliated Hospital of Nanchang University,Nanchang 330000,China;Nanchang University,Nanchang 3330019,China;The Laboratory Center,The First AffiliatedHospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院感染控制中心,江西南昌330000 [2]南昌大学,江西南昌330019 [3]南昌大学第一附属医院检验中心,江西南昌330000

出　　处：《标记免疫分析与临床》2025年第2期309-314,362,共7页Labeled Immunoassays and Clinical Medicine

基　　金：江西省教育厅科学技术研究项目(编号:GJJ2200208)。

摘　　要：目的分析烧伤患者创面感染的病原体特征及其影响因素,为预防创面感染提供参考。方法选取某三甲医院2021年9月至2023年9月收治的烧伤患者进行回顾性分析,根据是否出现创面感染设置感染组和对照组,各纳入159例患者。从电子病历系统收集患者的临床资料及创面检出病原体情况,通过Logistics回归分析烧伤患者创面感染的影响因素。结果159例感染患者检出病原菌192株,革兰氏阴性菌占58.33%,主要包括肺炎克雷伯杆菌、铜绿假单胞菌、鲍曼不动杆菌和阴沟肠杆菌等;革兰氏阳性菌以金黄色葡萄球菌为主;多重耐药菌有60株,检出率31.25%。Logistics回归分析显示,III度烧伤患者创面感染风险是II度烧伤患者的1.876倍(95%CI:1.003~3.507);联用3类及以上抗生素发生创面感染的风险是未联用抗生素的5.544倍(95%CI:1.926~15.957);应用封闭式负压引流术发生创面感染的风险降低48.8%(95%CI:14.8~69.3)。结论烧伤深度、联合使用抗生素、封闭式负压引流术是烧伤患者创面感染的影响因素,合理的干预措施能有效降低创面感染的发生。Objective To explore the pathogen characteristics and risk factors of wound infection in burn patients and to provide future references for the prevention and control of wound infection.Methods A retrospective analysis was conducted on the burn patients from September,2021 to September,2023 in a third-grade class-A hospital.Both infection group and control group were set up according to whether there was wound infection,with 159 patients included in each group.Clinical data and wound detected pathogens were collected from electronic medical record systems,and the risk factors of wound infection in burn patients were identified by logistics regression model.Results 192 strains of pathogen were detected in 159 infected patients,and Gram-negative bacteria accounted for 58.33%,mainly including Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Enterobacter cloacae.The Gram-positive bacteria were mainly Staphylococcus aureus.And there were 60 multi-resistant bacterial strains,with a detection rate of 31.25%.Logistics regression analysis showed that the risk of wound infection in patients with third-degree burn depth was 1.876 times that of patients with second-degree burn depth(95%CI:1.003-3.507).The incidence of wound infection was 5.544 times higher in patients receiving combination therapy with three or more types of antibiotics(95%CI:1.926-15.957).Patients who underwent vacuum sealing drainage had a 48.8%reduction in the incidence of wound infection(95%CI:14.8%-69.3%).Conclusion Burn depth and combined use of antibiotics are shown to be risk factors for wound infection,and VSD is a protective factor.According to the risk factors identified,appropriate intervention and treatment measures should be applied to reduce the occurrence of wound infection.

关 键 词：烧伤 创面感染 病原体 影响因素 

分 类 号：R644[医药卫生—外科学]