To explore the distribution and drug resistance of pathogens bacteria associated with central venous catheter (CVC)-related infection in severe burn patients, so as to provide clinical basis for prevention and reduction of CVC-related infection.

A prospective study was conducted. From January 2018 to December 2021, 148 patients with severe burn who met the inclusion criteria for CVC catheterization and hospitalized in Tongren Hospital of Wuhan University & Wuhan Third Hospital were recruited in the prospective study. Different nursing cares of patients were given to the CVC puncture site according to whether there was a wound or not. The puncture site and surrounding skin were disinfected with 5 g/L iodophor every 7 days at the place where the catheter was placed through normal skin. After drying, sterile 3M transparent application was applied to cover the catheter. The puncture site and surrounding skin were disinfected with 5 g/L iodophor every day at the wound catheterization site. After drying, the puncture site was covered with a double layer of sterile gauze, and the secretions were mostly changed when discharge was excessive. Semi-quantitative culture of bacteria at the tip of venous catheter was performed when CVC was decannulated. The drug sensitivity test was performed on the positive strains cultured by disk diffusion method to observe the species of pathogenic bacteria and their drug resistance.

All patients underwent 261 catheterizations. A total of 62 strains of pathogenic bacteria were isolated from all patients, including 41 strains of Gram negative bacteria accounting for 66.13%, 18 strains of Gram positive bacteria accounting for 29.03%, and 3 fungi accounting for 4.84%. The top five pathogens were Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Klebsiella pneumoniae and Staphylococcus epidermidis, and accounting for 35.48%, 19.35%, 14.52%, 8.06% and 6.45% respectively. The resistance rate of Pseudomonas aeruginosa to polymyxin B was 0, and were both more than 75.00% to cefepime and piperacillin, and it had different degrees of resistant to other antibiotics. The resistance rate of Acinetobacter baumannii to polymyxin B was 0, and to nine kinds of antibiotics except imipenem were all 100.00%. The resistance rates of Staphylococcus aureus to vancomycin, linezolid and quinuputin/dapfoptin were all 0, and to ampicillin and penicillin were all 100.00%. Staphylococcus aureus was severely resistant to other antibiotics.

Gram-negative bacteria are the main infections of CVC-related infection in sever burn patients, among which Pseudomonas aeruginosa is the first, and the drug resistance is severe. Medical staff should pay attention to it, strengthen observation and nursing, and rationally apply antibiotics according to the results of drug sensitivity test, so as to reduce the occurrence of CVC-related infections.