Influence Of Burn Infection On The Levels Of Immune Factors

Objectives1. To investigate a continous cases and monitor the pathogens colonization in the wound or nosocomial infection occurrence in a first class hospital burn unit of the third grade.Found the risk factors of influence on burn infection and pathogens colonization through analysis the vaious factors in different periods.According to different risk factors and taking a series of effective measures to decrease infection incidence and mortality.2. To test the expression levels of complement 3 (C₃) and interleukin-10 ( IL-10 ) in burn patient serum and analysis how the various factors influence on level changes in different periods,so that give appropriate clinical treatment and prevent post-burn immune dysfunction in post-burn. Methods1. According to the purpose designed a questionnaire in 4 aspects,which contained basic informations,the situation in use drugs,pathogens colonization in burn wound and burn infection,the levels of immune factors in serum in burn patients. Chose the 171 hospitalized patients from April to October in 2010,excluded the patients who suffered from heart,liver,kidney,brain diseases,high blood pressure,diabetes and immunological disease before injury.2. Collecting surface swabs in 3rd,7th,14th,21st in post-burn after washing the wound with sterile saline which is 0.9% concentration;Meanwhile,collected the peripheral blood 1～2ml and acquired serum by centrifuge in 3rd,7th,14th, checked out the expression levels of C₃ and IL-10 in serum with ezyme linked immunosorbent assay (ELISA) .3. Analysis the situation in pathogens colonization and burn infection in 3rd,7th,14th,21st and influence factors in postburn.Independent-Sample T test was used by counting material data,Crosstabs was used by measurement data,chosen the factors which were significant statistical (P<0.05),as whether infection dependent for variable,and as influence factors for independent variable,took into multiple regression equation and found the risk factors which influence pathogen colonization and burn infection by used Logistic-regression analysis.4. To test the influence factors in different periods in postburn, compared two independent samples with t (t')test, analyzed several independent samples after test the levels of C₃ and IL-10 inspection by ELISA with nonparametric Kruskal-Wallis test. Results1. Many kinds of pathogens was increasing with prolonged the hospitalization,11species pathogens were checked out in 14th and the positive ratio was 90.91%.Though the ratio and species became a little decreased in 21st,they were multi-drug restistant pathogens,such as MRSA,acinetobacter baumannii,pseudomonas aeruginosa,and so on .2. The ratio of G+ (Gram-positive bacteria) was 56.6% and G- (Gram-negative ) was 43.4% in the early postburn, G+ was decreasing and G- was increasing as the time gone.There was a significant statistical in the ratio of pathogens colonization and the composition of pathogens species in the wound in different periods(P<0.01),there also was a significantly statistics in the pathogens colonization in the wound influence burn infection(P<0.01).3. There were a significant statistical in 12 aspects factors influence pathgons colonization and 14 aspects factors influence burn infection(P<0.05)with single factor analysis.The results showed that two risk factors influence pathogens colonization,which were antimicrobials combine in 3rd and deep–Ⅱdegree wound in 7th. another two factors that may lead to burn infection,which were the length of hospitalization and invasive procedures treatment.4. There were no significant statistical in the levels of C₃ and IL-10 in different periods(P>0.05) with nonparametric Kruskal-Wallis test.Then analysis the factors that may influence the levels of C₃ and IL-10,the results showed that the significant statistical in some aspects in different periods,such as burn area,severity,the types of invasive procedures and wound treatment in the 3rd,the types of wound and wound treatment in the 7th,the antibiotics combine in the 14th(P<0.05).But which were showed no significant statistical influence on the levels of IL-10 (P>0.05).5. There were significant statistics in wound colonization influence on the levels of C₃ in 3rd ,single wound infection combine other site or sepis influence the levels of IL-10 in 14th (P<0.05),and increased to twice the single.Conclusions1. It's different in the ratio of pathogens colonization and species in every periods with the length of hospitalization.Although there was decreasing in the ratio of 21st ,5 pathogens were showed a trend which was becoming multi-drug resistant.2. Hospitalized was prolonged and invasion increased the risk of infection and made the pathongens translated from environment.Combine the broad-spectrum antibiotics destructed the balance of micro-encology,which made the pathongens translation from flora and colonization in the wound;the 7th was the risk period of pathongens conlonized in deep-Ⅱdegree wound.3. Because of the compex situation and serious body damage in electric burn injury,the levels of C₃ and IL-10 in these patients'serum were higher than the others.4. There were no significant influence in simple wound infection ,but if the levels of IL-10 upped to 2 times ,it's suggested that infection may became more serious and related to immue dysfunction or excessive inflammatory reaction.