Analysis On The Drug Resistance And Infection-related Factors Of Pathogen In Chronic Refractory Wounds

Objective: We investigated the clinical distribution and drug resistance rate of pathogenic bacteria on chronic refractory wounds,and risk factors of infection were evaluated as well.We expect to provide evidence for clinical anti-infection treatment.Methods: The clinical data of 183 patients with chronic refractory wounds from October 2016 to December 2018 were collected and analyzed.The pathogenic bacteria isolated and cultured from the wounds,then the distribution of bacteria,drug sensitivity rates and risk factors of wound infection were analyzed.Results: 180 strains of pathogenic bacteria were isolated in total,containing Gram-negative(G-)bacteria(59.4%)and Gram-positive(G+)bacteria(38.4%).The drug resistance of G-bacteria was more serious than that of G+ bacteria.Pseudomonas aeruginosa was resistant to ampicillin,ceftriaxone,amitracillin,cefoperazone/sulbactam and imipenem;E.coli was resistant to ampicillin,ampicillin/sulbactam,cefazoline,ceftriaxone,tobramycin,ciprofloxacin,levofloxacin and compound xinnomin.Regarding Acinetobacter baumannii,it was resistant to majority of antibiotics except polymyxin B,and the drug resistance rate was more than 80%.However,Acinetobacter baumannii was sensitive to tegacycline,and the sensitivity rate and mediation rate were 18.2% and 45.5% respectively.Moreover,G+ bacteria were highly sensitive to vancomycin and linezolid,but the drug resistances for benzylpenicillin,tetracycline,clindamycin,erythromycin could not be ignored.Staphylococcus aureus acted as the major G+ bacteria,in which methicillin-resistant Staphylococcus aureus(MRSA)accounted for 1/3.The unique effective antibiotic for MRSA is vancomycin currently.The wound secretions of 183 patients were collected,and bacteria culture was performed.There were 150 positive cases of bacteria culture and 33 negative cases.Single factor analysis showed that the risk factors included deep wound(deeper than superficial skin,P<0.01),long-term bedridden(P=0.031),low hemoglobin(P=0.005),hypoalbuminemia(P=0.016),high blood glucose(P=0.027)and recent use of antibiotics(P=0.046).Conclusion: We conducted a comprehensive summary of species and drug resistance characteristics of pathogenic bacteria on chronic refractory wounds,and risk factors of infection were evaluated as well.It is seemed to be necessary for the treatment with reasonable antibiotics application of chronic refractory wound infection.