| Objectives: Explore the distribution of pathogenic bacteria on the wounds of burn patients and the changes in drug resistance,analyze the risk factors that affect wound infections,and provide a theoretical basis for the rational use of antibiotics to prevent and control wound infections for clinical treatment of burn patients..Methods: 1.Collect the wound secretion specimens of 182 burn patients from 2018 to 2020 for bacterial culture processing,conduct drug sensitivity tests on commonly used clinical antibiotics,and compare the distribution and drug resistance of pathogenic bacteria on the wounds of192 burn patients from 2015 to 2017.2.SPSS22 statistical software for data analysis.Take 374 patients as the research object.Single factor combined with multi-factor analysis to determine the risk factors of wound infection,the risk factors are analyzed in detail.Results: In the distribution of pathogens,In 2015-2018,Gramnegative bacteria,Gram-positive bacteria,and fungi accounted for 50.3%,43.9%,and 5.9%,respectively.The top 5 are Staphylococcus aureus,Escherichia coli,Staphylococcus epidermidis,Pseudomonas aeruginosa,Klebsiella pneumonia.During 2018-2020,gram-negative bacteria,grampositive bacteria,and fungi accounted for 57.1%,38.6%,and 4.2%,respectively.The top 5 are Staphylococcus aureus,Pseudomonas aeruginosa,Escherichia coli,Acinetobacter baumannii,and Klebsiella pneumoniae.The difference between the two groups was statistically significant(P<0.05).In the analysis of the resistance of pathogenic bacteria to antibiotics,gram-positive bacteria generally have the lowest resistance to teicoplanin.The resistance of gram-negative bacilli to antibiotics is not exactly the same in two different time periods,but the antibiotic with the lowest resistance has not changed.Pseudomonas aeruginosa has the lowest resistance to Laoxycephalosporium,while Escherichia coli,Acinetobacter baumannii,and Klebsiella pneumoniae have the lowest resistance to tigecycline.The results of single factor combined multivariate analysis were deep burns(deep II° and III°),hypoproteinemia,shock,burn area(more than 35% TBSA),length of hospital stay(more than 30 days),history of diabetes or abnormal blood sugar in hospital It is a risk factor for wound infection.Negative pressure aspiration surgery on the wound surface and the combination of scab grinding and covering of xenogeneic acellular dermis are protective factors for wound infection.Conclusions: Gram-negative bacilli dominate the burn wound infections,and with the passage of time,the proportion of gram-negative bacteria increases,and the resistance of pathogens to antibiotics is mostly increasing.Gram-positive bacteria are generally suitable for teicoplanin.Among the gram-negative bacilli,Pseudomonas aeruginosa is the least resistant to Laoxycephalosporium.All other gram-negative bacilli are resistant to tigecycline.lowest.Admission to the hospital with deep burns(deep II° and III°),burn area(more than 35% TBSA),length of hospital stay(more than 30 days),hypoproteinemia,shock,history of diabetes or abnormal blood sugar in hospital,etc.After treatment,the infection should be corrected as soon as possible.Negative pressure suction operation and combined scab grinding to cover xenogeneic acellular dermis can reduce wound infection. |
