烧伤护理中的沙雷菌感染。

IF 1.5 4区 医学 Q3 CRITICAL CARE MEDICINE Journal of Burn Care & Research Pub Date : 2025-01-13 DOI:10.1093/jbcr/iraf004
David Wallace, Alan D Rogers
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引用次数: 0

摘要

粘质沙雷菌是一种机会性医院病原体,由于其耐多药、毒力和在医院环境中定植的能力,对烧伤护理具有重要意义。这项回顾性研究在美国烧伤协会认证的烧伤中心进行,回顾了2015年至2020年22例粘质葡萄球菌感染病例。患者表现出平均体表面积(TBSA)烧伤28%(范围:2-71%),68%持续烧伤,20% TBSA, 40.9%为吸入性损伤。病原菌最常见于痰液(36%)和烧伤创面组织(50%),平均阳性培养时间为8.7天。早发性感染与死亡率增加有关,特别是在严重烧伤患者中,因为七分之五的患者死于感染。尽管及时使用抗生素,但总死亡率为23%。靶向局部抗菌剂,如Dakin溶液、纳米晶银和聚六亚甲基二胍(PHMB),提供了潜在的益处,但缺乏可靠的证据证明最佳使用。需要更有力的临床数据来指导它们的应用和改善结果。这些发现强调了加强监测、改进治疗策略和研究粘多糖在烧伤护理中的管理的必要性。
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Serratia Infections in Burn Care.

Serratia marcescens is an opportunistic nosocomial pathogen with significant implications for burn care due to its multidrug resistance, virulence, and ability to colonize hospital environments. This retrospective study, conducted at an American Burn Association Verified Burn Centre, reviewed 22 cases of S. marcescens infections from 2015 to 2020. Patients exhibited a mean total body surface area (TBSA) burned of 28% (range: 2-71%), with 68% sustaining burns >20% TBSA and 40.9% presenting with inhalation injuries. The pathogen was most commonly isolated from sputum (36%) and burn wound tissue (50%), with a mean time to positive culture of 8.7 days. Early-onset infections were associated with increased mortality, particularly in patients with major burns, as five out of seven such individuals succumbed to infection. The overall mortality rate was 23%, despite timely antibiotic administration. Targeted topical antimicrobials, such as Dakin's solution, nanocrystalline silver, and polyhexamethylene biguanide (PHMB), offer potential benefits but lack robust evidence for optimal use. Stronger clinical data are needed to guide their application and improve outcomes. These findings underscore the need for enhanced surveillance, refined treatment strategies, and research into S. marcescens management in burn care.

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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
535
审稿时长
4-8 weeks
期刊介绍: Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.
期刊最新文献
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