Investigation On The Distribution Characteristics And Drug Resistance Of Pathogenic Bacteria On Burn Wounds In A Tertiary Hospital

Objective: To investigate the detection rate of pathogenic bacteria on the wounds of burn patients and figure out the evolution trend of main pathogen types and the changes in drug resistance to provide a scientific basis for the rational use of antibacterial drugs in burn patients.Methods:The clinical data of 325 burn inpatients admitted to the burn and plastic surgery ward of a tertiary hospital in Taizhou from January 2016 to December 2020 were retrospectively analysed,and the detection results and drug resistance of 1007 pathogenic bacteria were collected,and then figure out the distribution of the detection rate and the trend of the drug resistance of the main pathogens.Results: 1.There were 325 burn cases in the burn plastic surgery ward of the hospital that met the selection criteria.A total of 1,007 strains of pathogenic bacteria were cultured in the infectious specimens submitted for inspection,mainly Gram-negative bacteria G~-(69.31%),followed by Grams Positive bacteria G~+(28.51%),and finally fungus(2.18%).The top 4 isolation rates are: Acinetobacter baumannii(23.34%),Klebsiella pneumoniae(21.35%),Staphylococcus aureus(15.79%),and Pseudomonas aeruginosa(7.65%).2.The detection of Acinetobacter baumannii and Klebsiella pneumoniae showeda downward trend in recent years(P<0.01).Except for the two gram-negative bacteria which accounted for a relatively low level in 2018,the remaining annual percentages always maintain a high level.The detection rate of Staphylococcus aureus has been ranked third in 2016 and 2017.In 2018,it became the strain with the highest detection rate.In 2019 and 2020,the detection rate dropped again.The difference in annual detection rate of this pathogen in 5 years was statistically significant(P<0.01).The detection rate of Pseudomonas aeruginosa was always at a low level.The detection rate of fungi showed an upward trend(P<0.01).3.Staphylococcus aureus,Acinetobacter baumannii,and Klebsiella pneumoniaeall showed high drug resistance.Among them,the detection rate of multi-drug resistant bacteria is higher,and the drug resistance is more serious.There are 5 kinds of antibacterial drugs with resistance rate of methicillin-resistant Staphylococcus aureus>90%,including penicillin,clindamycin,erythromycin,tetracycline and oxacillin.Carbapenem-resistant Acinetobacter baumannii maintains high sensitivity only to colistin,minocycline,and tigecycline.Carbapenem-resistant Klebsiella pneumoniae was highly drug-resistant except for colistin.Conclusions:The pathogens of wound infections in the burn and plastic surgery ward of the hospital were mainly G~-,and the most common were Acinetobacter baumannii and Klebsiella pneumoniae,and Staphylococcus aureus was the most common in G~+.The detection rate of the main common pathogens in each year was related to their drug resistance.Both Acinetobacter baumannii and Klebsiella pneumoniae exhibited high drug resistance.The changes in the environment of the hospital may had a certain degree of impact on the infection rate,pathogen detection rate and drug resistance of burn patients.The resistance of multi-drug resistant strains was very severe.Intensified clinical monitoring,timely adjustment of the use of antibacterial drugs,and reasonable preventive measures based on specific conditions can control and reduce the incidence of infection.