Analysis Of Clinical Features For Nosocomial Infection In Mutiple Trauma Patients

Objective To explore clinical features and pathogens of multiple trauma patients with nosocomial infection(NI).Methods A retrospective study was carried out. A total of 360 multiple trauma patients admitted to the First Affiliated Hospital Of Guangxi Medical University from January 2012 to December 2014 were reviewed. Divided them into two groups, infection group (n=118) and no infection group (n=242). Selected factors form epidemiological background, laboratory examination indexes and treatment measures for statistical analysis. Pathogens were be grouped according to the different isolating year in order to explore the changes of pathogen spectrum and antibiotic resistance.Result A total of 360 multiple trauma patients were enrolled, and 118 had NI. There was a difference between the sites of NI (X2=182.7, P<0.01), pulmonary infection account for 61.9%, urinary system 12.7%, abdominal infection 10.2%, wound infection 8.5%, blood infect 5.1%, others 1.7%. There was a difference infection rate between the major injury parts(P<0.01), craniocerebral injury had the highest infection rate 49.0%, then was the thoracic injury39.1%, spinal injury(include paraplegia)37.5%. ISS score、GCS score、 chronic health condition、blood platelet count、blood glucose、albumin concentration、prothrombin time、emergency operation、trachea intubation、 tracheotomy、deep vein catheterization、mechanical ventilation、MODS and hemorrhagic shock had a statistical significance difference between the group of infection and no infection (P<0.05). The formation of pathogens in different years had no statistical significance (P=0.75), main of which was gram negative bacteria, candida were secondly and gram positive bacteria is the minimal. The most common bacterias were Klebsiella pneumonia、Acinetobacter baumannii and Pseudomonas aeruginosa, which’s drug sensitive test showed that the drug resistance rate was in an increasing tendency, especially Acinetobacter baumannii, the statistical of 2014 shows that besides cefoperazone-sulbactam, the drug resistance rate greater than 80% of the tested drugs, including of carbapenems such as meropenem 84.2%, imipenem 89.5%.Conclusion The most common site of NI in multiple trauma patients was pulmonary, craniocerebral injury patients had the highest infection rate. NI in multiple trauma patients was relate to ISS score、GCS score、chronic health condition、blood platelet count、blood glucose、albumin concentration、 prothrombin time、emergency operation、trachea intubation、tracheotomy、deep vein catheterization、mechanical ventilation、MODS and hemorrhagic shock. The major pathogens of NI were gram negative bacterias, secondly was candida, gram positive bacteria was the minimal. The most common bacterias were Klebsiella pneumonia、Acinetobacter baumannii and Pseudomonas aeruginosa, which’s drug sensitive test showed that the drug resistance rate was in an increasing tendency.