在烧伤重症监护室探索感染风险因素和多药耐药生物 (MDROs):一个多中心病例控制研究
S Nasser1, Z Alnasser1, O Aljuhani2
1Department of Nursing, College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia; Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
The Journal of hospital infection
|June 2, 2025
概括
严重烧伤患者的烧伤表面面积较大,格拉斯哥昏迷表得分较低,面临多种耐药生物体 (MDRO) 感染的风险更高. 这些感染导致更长的重症监护室停留.
科学领域:
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
- 燃烧管理 燃烧管理
背景情况:
- 多重耐药生物 (MDRO) 在烧伤中心普遍存在,但严重烧伤患者感染的风险因素仍未得到充分研究.
- 这项研究通过调查MDRO获取风险和在烧伤重症监护室 (BICU) 的患病率来解决这个差距.
研究的目的:
- 为了确定危急性烧伤患者中多药耐药生物体 (MDRO) 获取的风险因素.
- 为了确定MDRO感染在这个脆弱的患者群体中的患病率.
主要方法:
- 进行了一项多中心观察病例控制研究,涉及2015年至2022年入院BICU的成年烧伤患者.
- 排除标准包括烧伤<10%TBSA,24小时内死亡,未知伤害时间,先前的MDRO感染或最近的抗生素使用.
- 使用基于年龄,性别和入学年份的精确匹配方法 (1:1) 进行了后勤和线性回归分析.
主要成果:
- 较低的格拉斯哥昏迷量表 (GCS) 评分,更高的序列器官衰竭评估 (SOFA) 和APACHE II评分,侵入性机械通风和更大的全身表面积 (TBSA) 受到影响与MDRO获得有关.
- 回归分析证实了较低的GCS,更大的TBSA受影响,以及尿路感染作为MDRO感染的重要风险因素.
- Acinetobacter baumannii是最常见的病原体 (57%),肺炎是最常见的感染 (52.4%). 患有MDRO的患者经历了更长的机械呼吸和ICU停留时间.
结论:
- 增加的TBSA受影响,较低的GCS得分和较高的SOFA/APACHE II得分显著提高了烧伤患者中MDRO感染的风险.
- 建议进行更大的样本规模研究,以验证这些发现并为临床实践提供信息.
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