Different Infection Profiles and Antimicrobial Resistance Patterns Between Burn ICU and Common Wards.
Different Infection Profiles and Antimicrobial Resistance Patterns Between Burn ICU and Common Wards.
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DOI：
10.3389/fcimb.2021.681731
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发表时间：
2021
影响因子：
5.7
通讯作者：
Li H
中科院分区：
文献类型：
--
作者：
Gong Y;Peng Y;Luo X;Zhang C;Shi Y;Zhang Y;Deng J;Peng Y;Luo G;Li H
感染是烧伤后并发症和死亡的主要原因。然而，烧伤重症监护病房（BICU）和烧伤普通病房（BCW）之间感染模式的差异尚未得到明确调查。本研究旨在比较 BICU 和 BCW 烧伤患者的感染情况、抗菌药物耐药性及其变化模式。临床样本于2011年1月1日至2019年12月31日在中国西南烧伤研究所进行分析。回顾性收集患者信息、病原菌分布、来源及抗菌药物耐药性。 BICU和BCW分别共检测到3457株和4219株菌株。 BCW和BICU中伤口分泌物分别占86.6%和44.9%。与BCW样本相比，BICU样本中真菌较多（11.8% vs. 8.1%），革兰氏阴性菌较多（60.0% vs. 50.8%），革兰氏阳性菌较少（28.2% vs. 41.1%）。与 BCW 中的金黄色葡萄球菌相比，鲍曼不动杆菌是 BICU 中最常见的病原体。金黄色葡萄球菌是 BICU 和 BCW 伤口分泌物和组织中最常见的病原体。然而，鲍曼不动杆菌首次出现在 BICU 的血液、痰液和导管样本中。总体而言，BICU 的多重耐药 (MDR) 率高于 BCW。然而，2011年至2019年，BICU与BCW之间的差距逐渐缩小。耐多药鲍曼不动杆菌和肺炎克雷伯菌的患病率显着增加，尤其是BCW。此外，BICU（2011 年为 4.5%，2019 年为 40%）和 BCW（2011 年为 0%，2019 年为 40%）肺炎克雷伯菌的碳青霉烯类耐药性显着增加。然而，BICU中耐多药铜绿假单胞菌的比例从85.7%急剧下降至24.5%。 BICU中MRSA的发生率显着高于BCW（94.2%比71.0%），并且BICU中MRSA的发生率仍处于较高水平（89.5%比96.3%）。热带念珠菌和白色念珠菌是两种最常见的真菌。未检测到对两性霉素 B 的耐药性。我们的研究表明，BICU 和 BCW 之间的感染情况不同，BICU 的多重耐药性比 BCW 更严重。因此，针对不同烧伤人群应采取不同的感染控制策略。
Infection is the leading cause of complications and deaths after burns. However, the difference in infection patterns between the burn intensive care unit (BICU) and burn common wards (BCW) have not been clearly investigated. The present study aimed to compare the infection profile, antimicrobial resistance, and their changing patterns in burn patients in BICU and BCW. Clinical samples were analyzed between January 1, 2011, and December 31, 2019, in the Institute of Burn Research in Southwest China. The patient information, pathogen distribution, sources, and antimicrobial resistance were retrospectively collected. A total of 3457 and 4219 strains were detected in BICU and BCW, respectively. Wound secretions accounted for 86.6% and 44.9% in BCW and BICU, respectively. Compared with samples in BCW, samples in BICU had more fungi (11.8% vs. 8.1%), more Gram-negative bacteria (60.0% vs. 50.8%), and less Gram-positive bacteria (28.2% vs. 41.1%). Acinetobacter baumannii were the most common pathogen in BICU, compared with Staphylococcus aureus in BCW. S. aureus was the most frequent pathogen in wound secretions and tissues from both BICU and BCW. However, A. baumannii were the first in blood, sputum, and catheter samples from BICU. Overall, the multidrug-resistance (MDR) rate was higher in BICU than in BCW. However, the gap between BICU and BCW gradually shortened from 2011 to 2019. The prevalence of MDR A. baumannii and Klebsiella pneumonia significantly increased, especially in BCW. Furthermore, Carbapenem resistance among K. pneumoniae significantly increased in BICU (4.5% in 2011 vs. 40% in 2019) and BCW (0 in 2011 vs. 40% in 2019). However, the percentage of MDR P. aeruginosa sharply dropped from 85.7% to 24.5% in BICU. The incidence of MRSA was significantly higher in BICU than in BCW (94.2% vs. 71.0%) and stayed at a high level in BICU (89.5% to 96.3%). C. tropicalis and C. albicans were the two most frequent fungi. No resistance to Amphotericin B was detected. Our study shows that the infection profile is different between BICU and BCW, and multidrug resistance is more serious in BICU than BCW. Therefore, different infection-control strategies should be emphasized in different burn populations.
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中国烧伤研究所耐碳青霉烯类鲍曼不动杆菌多位点序列分型分析
影响因子：
5.2
作者：
Huang G;Yin S;Gong Y;Zhao X;Zou L;Jiang B;Dong Z;Chen Y;Chen J;Jin S;Yuan Z;Peng Y
通讯作者：
Peng Y
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影响因子：
5.2
作者：
Jiang B;Yin S;You B;Huang G;Yang Z;Zhang Y;Chen Y;Chen J;Yuan Z;Rao X;Hu X;Gong Y;Peng Y
通讯作者：
Peng Y
影响因子：
56.3
作者：
Jault, Patrick;Leclerc, Thomas;Gabard, Jerome
通讯作者：
Gabard, Jerome
DOI：
10.1007/s10096-019-03673-1
发表时间：
2019-12-01
影响因子：
4.5
作者：
Hu, Fupin;Guo, Yan;Yue, Chunlei
通讯作者：
Yue, Chunlei
影响因子：
4.9
作者：
Maurel, Veronique;Denis, Blandine;Legrand, Matthieu
通讯作者：
Legrand, Matthieu