Pathogenetic characteristics and risk factor analysis of nosocomial infection with multidrug-resistant organisms in trauma patients
10.3760/cma.j.cn501098-20250114-00031
- VernacularTitle:创伤患者院内多重耐药菌感染的病原学特点及危险因素分析
- Author:
Shilan LUO
1
;
Ruiming ZHANG
;
He JIN
;
Li YANG
;
Baosheng YANG
;
Guodong LIU
Author Information
1. 中国人民解放军联勤保障部队第九二六医院烧伤整形科，开远 661600
- Publication Type:Journal Article
- Keywords:
Wounds and injuries;
Drug resistance, bacterial;
Infection;
Risk factors
- From:
Chinese Journal of Trauma
2025;41(4):391-398
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the pathogenetic characteristics and risk factors of nosocomial infection with multidrug-resistant organisms (MDRO) in trauma patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 103 trauma patients with nosocomial infection admitted to the 926th Hospital of the Joint Logistics Support Force of the PLA from January 2021 to December 2023, including 84 males and 19 females aged 12-80 years [50(39, 59)years]. The patients were divided into MDRO infection group ( n=36) and non-MDRO infection group ( n=67) according to whether nosocomial MDRO infection occurred. The pathogenetic characteristics of MDRO infection were observed. Univariate analysis was used to compare the two groups in terms of their demographic characteristics (gender, age), comorbidities (hypertension, diabetes mellitus), injuries [multiple injuries, open injuries, injury severity score (ISS)], laboratory indicators (hemoglobin, leukocytes) on admission, and other treatment data (emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, tracheotomy/tracheal intubation before diagnosis of infection). Logistic regression analysis was used to screen the independent risk factors for nosocomial MDRO infection in trauma patients. Results:A total of 52 MDRO strains were detected, including 17 Gram-positive (33%) and 35 Gram-negative (67%) ones, with the top 5 strains being Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae, and Staphylococcus epidermidis, respectively. The specimen source with the most detected MDRO strains was wound/incision secretion, followed by sputum. The results of the univariate analysis showed statistically significant differences in ISS and hemoglobin on admission between two groups ( P<0.05); however, no statistically significant differences were observed in gender, age, hypertension, diabetes mellitus, multiple injuries, open injuries, leukocytes on admission, emergency admission to the healthcare facility, transferal, length of hospital stay before diagnosis of infection, number of surgeries before diagnosis of infection, blood transfusion before diagnosis of infection, or tracheotomy/tracheal intubation before diagnosis of infection ( P>0.05). The results of the multivariate Logistic regression analysis showed that male gender ( OR=5.01, 95% CI 1.09, 23.08, P<0.05), age ( OR=1.03, 95% CI 1.00, 1.07, P<0.05), multiple injuries ( OR=5.28, 95% CI 1.04, 26.87, P<0.05), hemoglobin on admission ( OR=0.97, 95% CI 0.95, 0.99, P<0.05), and length of hospital stay before diagnosis of infection ( OR=1.06, 95% CI 1.01, 1.11, P<0.05) were significantly associated with the occurrence of nosocomial MDRO infection in trauma patients. Conclusions:In trauma patients, nosocomial MDRO infection pathogens were predominantly Gram-negative and the top five strains are Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae and Staphylococcus epidermidis, respectively. Male gender, age, multiple injuries, hemoglobin on admission and length of hospital stay before diagnosis of infection are independent risk factors for the occurrence of nosocomial MDRO infection in trauma patients.
