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严重的死软组织感染 - - 伤口微生物学是否是临床结果的预后因素?

Jan Friederichs¹, Benedikt Gerl¹, D Schneidmüller¹

¹Trauma and Orthopedic Surgery, BG Unfallklinik Murnau, Murnau, Germany.

International wound journal

|August 30, 2023

概括

末性软组织感染 (NSTI) 呈现不同的临床过程. 早期的Streptococcus pyogenes检测是关键,而后来的Enterococci和真菌表明死亡风险更高.

科学领域:

传染性疾病传染性疾病
微生物学微生物学
临界护理医学临界护理医学

背景情况:

死性软组织感染 (NSTI) 呈现不同的临床轨迹,从亚急性到 fulminant 败血症.
最初的伤口微生物学指导了分类,但时间变化和病原体特异性结果仍然不清楚.

研究的目的:

分析NSTIs中微生物殖民的时间表.
为了将病原体动态与患者的结果和死亡风险相关联.

主要方法:

在入院时对180名患有败血性炎症反应综合征的患者进行了回顾性分析.
追踪初始和连续的伤口微生物学,将发现与临床结果和风险指标相关联.

主要成果:

总的死亡率为35%. 较高的年龄,并发症得分和骨干感染预测了致命的结果.
链球菌被检测得较早 (≤5天),而其他细菌持续时间较长.
肠球菌和真菌的死亡率最高,这表明它们的作用被低估了.

结论:

微生物殖民模式在NSTI进展过程中演变,并预测患者的结果.
经常被忽视的肠球菌和真菌是NSTIs预后恶化和死亡率增加的重要指标.

关键词:

这是NSTI的NSTI.微生物学的微生物.死性粘膜炎的发生.死的软组织感染.有关风险因素的风险因素.

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