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当院救急部の重症熱傷患者における細菌感染 : 最近10年間の成績

フォーマット:
論文(リポジトリ)
責任表示:
吉川, 恵次 ; 遠藤, 裕 ; 佐藤, 一範 ; 渡辺, 逸平 ; 篠永., 真弓 ; 河井, 一浩 ; 伊藤, 雅章
出版情報:
新潟医学会, 1998-12
掲載情報:
新潟医学会雑誌 — 新潟医学会雑誌
ISSN:
00290440  CiNii Research  Webcat Plus  JAIRO
著者名:
吉川, 恵次
遠藤, 裕
佐藤, 一範
渡辺, 逸平
篠永., 真弓
河井, 一浩
伊藤, 雅章
続きを見る
巻:
112
通号:
12
開始ページ:
777
終了ページ:
788
概要:
Significant advances in the management for burned patients, such as fluid therapy, burn wound excision, and stress ulcer prevention, have further accentuated infection as more frequent cause of morbidity and mortality. The present study was conducted to clarify the various microbiological aspects in 28 burn patients who were admitted to and survived early shock stage at the Emergency and Critical Care Unit at Niigata University Hospital from 1986 through 1996. Results:1) Cause of all the 3 died patients was the severe infection. 2) The systemic prophylactic antibiotics most commonly used in the early stage of management was cephazolin (CEZ), while povidone iodine and silver sulphadiazine were the most popular topical agents. 3) Burn wound infection (including colonization) was observed in 13 patients (46%). The main organisms from burn wound were MRSA, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans. These organisms remained at the wound during the long period of the clinical course. 4) Pneumonia, urinary tract infection, intravenous catheter tip infection, and sepsis (septic symptoms with bacteremia) were observed in 4, 7, 4 and 4 patients, respectively. In many cases, common organisms to those from the burn wound were isolated from their relevant specimens. 5) MRSAs were detected in 9 patients, although there were no succumbed patients, nor patients suffered from MRSA pneumonia or enteritis among them. 6) Culture results showed that all the isolated strains of MRSA and Enterococcus faecalis were vancomycin-sensitive. Comprehensive management including not only the use of adequate topical and systemic antibacterial agents, but debridement of the devitalized tissue, nutritional support which enhance the host defense mechanism, and etc. would be essential to prevent infection of burned patients. 続きを見る
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