在创伤患者中引起感染的细菌和真菌病原体的时间序列
Frederique J C van Eerten1, Miquel B Ekkelenkamp2, Joost D J Plate3
1Department of Trauma Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Trauma surgery & acute care open
|August 27, 2025
概括
创伤患者的感染表现出一种病原体序列, 随着时间的推移, 这种模式表明长期免疫失衡会导致严重伤害后几周的感染.
科学领域:
- 传染性疾病
- 创伤手术
- 免疫学
背景情况:
- 免疫力受损的重症监护室 (ICU) 患者容易感染病原体.
- 严重受伤的患者可能会出现类似的免疫缺陷,延长感染风险.
- 通过抗生素选择的在医院获得的病原体可以在这些易受感染的患者中引起感染.
研究的目的:
- 研究严重受伤患者感染的时间.
- 在创伤后的不同时间点识别引起感染的病原体.
主要方法:
- 一级创伤中心的回顾性队列研究 (2013-2022年).
- 包括严重受伤的ICU停留时间超过48小时的患者.
- 记录的感染 (CDC标准) 和引起病原体,注意创伤后几天的时间.
主要成果:
- 109/572严重受伤的患者出现感染性并发症.
- 观察到不同的病原体时间序列.
- 早期感染 (在40天前) 与黄金杆菌 (Staphylococcus aureus) 和杆菌 (Enterococcus) 相关;晚期感染 (在60天后) 与克莱布西拉 (Klebsiella) 菌种 (Candida) 菌种 (Enterobacter) 和伪杆菌 (Pseudomonas) 菌种 (Pseudomonas) 相关.
结论:
- 严重受伤的患者表现出导致感染的病原体的时间序列.
- 起初共生微生物占主导地位,随着时间的推移转向医院获得的病原体.
- 这一序列支持了先天免疫系统持续失衡导致晚期感染的假设.
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