Biofilms and persistent wound infections in United States military trauma patients: a case-control analysis.
Biofilms and persistent wound infections in United States military trauma patients: a case-control analysis.
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DOI：
10.1186/1471-2334-14-190
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发表时间：
2014-04-08
影响因子：
3.7
通讯作者：
Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group
中科院分区：
文献类型：
--
作者：
Akers KS;Mende K;Cheatle KA;Zera WC;Yu X;Beckius ML;Aggarwal D;Li P;Sanchez CJ;Wenke JC;Weintrob AC;Tribble DR;Murray CK;Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group
军事人员遭受的复杂创伤，特别是涉及四肢的创伤，往往会导致感染性并发症和大量发病率。可能进一步损害患者康复的一个因素是感染的持久性。表面附着的微生物群落，称为生物膜，可能在阻碍感染管理方面发挥作用；然而，缺乏将生物膜的形成与持续性或慢性感染联系起来的临床数据。因此，我们评估了细菌生物膜的产生作为伤员持续感染的潜在危险因素。通过创伤感染性疾病结果研究收集了与部署相关的军事人员的细菌分离和临床数据。研究人群包括被诊断为皮肤和软组织感染的患者。将病例(间隔14天收集的具有相同微生物的细菌分离物的伤口)与对照(具有非复发细菌分离物的伤口)进行比较，后者与机体和传染病综合征相匹配。持续感染的潜在危险因素，包括生物膜的形成，在单变量分析中进行了检查。数据以优势比(OR；95%可信区间[CI])表示。在每个感染伤口的基础上，确定了35例(代表25名患者)和69名对照(代表60名患者)。8例多发伤患者作为病例组和对照组。在病例对照分析中，总共测试了235株细菌分离株的生物被膜形成情况。在单变量分析中，生物膜的形成与感染持久性显著相关(OR：29.49；CI：6.24-无穷大)。多药耐药(OR：5.62；CI：1.02~56.92)、24小时内红细胞输注要求(OR：1.02；CI：1.01~1.04)、感染诊断前及确诊当日是否去手术室(OR：2.05；CI：1.09~4.28)、感染伤口解剖部位(OR：5.47；CI：1.65~23.39)、是否发生多菌感染(OR：69.71；CI：15.39~无限)也是持续感染的重要危险因素。我们发现，临床菌株产生的生物被膜与伤口感染的持久性显著相关。然而，由于样本量小，分析的统计能力有限，不可能进行多变量分析。需要进一步的数据来确认生物膜的形成是持续性伤口感染的危险因素。
Complex traumatic injuries sustained by military personnel, particularly when involving extremities, often result in infectious complications and substantial morbidity. One factor that may further impair patient recovery is the persistence of infections. Surface-attached microbial communities, known as biofilms, may play a role in hindering the management of infections; however, clinical data associating biofilm formation with persistent or chronic infections are lacking. Therefore, we evaluated the production of bacterial biofilms as a potential risk factor for persistent infections among wounded military personnel. Bacterial isolates and clinical data from military personnel with deployment-related injuries were collected through the Trauma Infectious Disease Outcomes Study. The study population consisted of patients with diagnosed skin and soft-tissue infections. Cases (wounds with bacterial isolates of the same organism collected 14 days apart) were compared to controls (wounds with non-recurrent bacterial isolates), which were matched by organism and infectious disease syndrome. Potential risk factors for persistent infections, including biofilm formation, were examined in a univariate analysis. Data are expressed as odds ratios (OR; 95% confidence interval [CI]). On a per infected wound basis, 35 cases (representing 25 patients) and 69 controls (representing 60 patients) were identified. Eight patients with multiple wounds were utilized as both cases and controls. Overall, 235 bacterial isolates were tested for biofilm formation in the case–control analysis. Biofilm formation was significantly associated with infection persistence (OR: 29.49; CI: 6.24-infinity) in a univariate analysis. Multidrug resistance (OR: 5.62; CI: 1.02-56.92), packed red blood cell transfusion requirements within the first 24 hours (OR: 1.02; CI: 1.01-1.04), operating room visits prior to and on the date of infection diagnosis (OR: 2.05; CI: 1.09-4.28), anatomical location of infected wound (OR: 5.47; CI: 1.65-23.39), and occurrence of polymicrobial infections (OR: 69.71; CI: 15.39-infinity) were also significant risk factors for persistent infections. We found that biofilm production by clinical strains is significantly associated with the persistence of wound infections. However, the statistical power of the analysis was limited due to the small sample size, precluding a multivariate analysis. Further data are needed to confirm biofilm formation as a risk factor for persistent wound infections.
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影响因子：
3.7
作者：
Dalton T;Dowd SE;Wolcott RD;Sun Y;Watters C;Griswold JA;Rumbaugh KP
通讯作者：
Rumbaugh KP
影响因子：
11.8
作者：
Donlan, R M
通讯作者：
Donlan, R M
影响因子：
64.5
作者：
Kolodkin-Gal I;Cao S;Chai L;Böttcher T;Kolter R;Clardy J;Losick R
通讯作者：
Losick R
影响因子：
5.4
作者：
Kostakioti M;Hadjifrangiskou M;Hultgren SJ
通讯作者：
Hultgren SJ
影响因子：
4.9
作者：
Kim, Jun-Seob;Heo, Paul;Kweon, Dae-Hyuk
通讯作者：
Kweon, Dae-Hyuk