Analysis of pathogens distribution and risk factors of burn infections in burn patients / 中华检验医学杂志

ABSTRACT

Objective:To investigate and analyze the distribution of pathogens and to explore the related risk factors of infections in burn patients in order to provide theoretical basis for effective prevention and treatment of wound infections in burn patients.Methods:A total of 245 burn patients, admitted to the PLA 926 Hospital from January 2016 to December 2020, were selected. The pathogens and antimicrobial susceptibility of the wound secretions were tested and the clinical data of burn patients were collected. The risk factors of burn wound infection were screened by single factor comparison method and multivariate logistic regression.Results:Among the 245 burn patients, 184 patients were with bacterial infections, the infection rate was 75.10% (184/245), and 79 patients were multi-drug resistant, accounting for 42.93%(79/184). A total of 367 strains of pathogens were isolated from wound secretions in the 184 patients, among which 72 (19.62%, 72/367) strains were gram-positive bacteria, mainly Staphylococcus aureus (11.44%, 42/367), 283 (77.11%, 283/367) strains were gram-negative bacteria, mainly Pseudomonas aeruginosa (20.16%, 74/367) and Acinetobacter baumannii (19.89%, 73/367), and 12 (3.27%, 12/367) strains were fungi, mainly Aspergillus (1.91%, 7/367). The results of drug sensitivity tests showed that the pathogens of burn patients were highly resistant to common antibiotics. Monofactor analysis showed that age(χ 2=8.629, P=0.013), burn area (χ 2=21.504, P=0.002), wound depth (χ 2=17.139, P=0.000), hypovolemic shock (χ 2=21.112, P=0.000) and length of hospital stay (χ 2=21.967, P=0.000) were the related risk factors for wound infections. Multivariate logistic regression analysis showed that ages below 4 years old or over 69 years old ( OR=8.414,95% CI2.971-23.830, P=0.000), burn area>30% ( OR=5.672,95% CI1.029-31.272, P=0.046), Ⅲ degree wound ( OR=4.069,95% CI1.396-11.858, P=0.010), length of hospital stay≥15 days ( OR=2.593,95% CI1.091-6.162, P=0.031) were the independent risk factors of wound infections in burn patients. Conclusions:The incidence of wound infection and multi-drug resistance is relatively high in burn patients, and the pathogens are mainly gram-negative bacteria. Age, burn area, burn wound depth and length of hospital stay are the high-risk factors for wound infections, and taking effective preventive measures according to risk factors can reduce the occurrence of wound infections and hospital infections.