Journal article
Timeline of health care–associated infections and pathogens after burn injuries
American journal of infection control, Vol.44(12), pp.1511-1516
12/01/2016
DOI: 10.1016/j.ajic.2016.07.027
PMCID: PMC5388443
PMID: 27742146
Abstract
•Of patients with burn injuries, 7% develop a hospital-acquired infection.•Gram-positive bacteria predominate early during the hospitalization after burn injury, whereas gram-negative bacteria become more common later during the admission.•Bacterial pathogens isolated from burn patients tend to become resistant to an increasing number of antibiotics as time from admission increases.
Infections are an important cause of morbidity and mortality after burn injuries. Here, we describe the time line of infections and pathogens after burns.
A retrospective study was performed in a large tertiary care burn center from 2004-2013. Analyses were performed on health care–associated infections (HAIs) meeting Centers for Disease Control and Prevention criteria and on all positive cultures. Incidence rates per 1,000 days were calculated for specific HAI categories and pathogens and across hospitalization time (week 1, weeks 2-3, and week ≥4).
Among 5,524 patients, the median burn size was 4% of total body surface area (interquartile range, 2%-10%). Of the patients, 7% developed an HAI, of whom 33% had >1 HAI episode. Gram-positive bacteria were isolated earlier, and gram-negative bacteria were isolated later during hospitalization. Of 1,788 bacterial isolates, 44% met criteria for multidrug resistance, and 23% met criteria for extensive drug resistance. Bacteria tended to become increasingly resistant to antibiotics as time from admission increased.
We observed differences in infection type, pathogen, and antibiotic-resistant bacterium risk across time of hospitalization. These results may guide infection prevention in various stages of the postburn admission.
Details
- Title: Subtitle
- Timeline of health care–associated infections and pathogens after burn injuries
- Creators
- David van Duin - University of North Carolina at Chapel HillPaula D. Strassle - University of North Carolina at Chapel HillLauren M. DiBiase - University of North Carolina Health CareAnne M. Lachiewicz - University of North Carolina at Chapel HillWilliam A. Rutala - University of North Carolina Health CareTimothy Eitas - Research Triangle Park FoundationRobert Maile - Research Triangle Park FoundationHajime Kanamori - University of North Carolina at Chapel HillDavid J. Weber - University of North Carolina Health CareBruce A. Cairns - University of North Carolina at Chapel HillSonia Napravnik - University of North Carolina at Chapel HillSamuel W. Jones - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- American journal of infection control, Vol.44(12), pp.1511-1516
- DOI
- 10.1016/j.ajic.2016.07.027
- PMID
- 27742146
- PMCID
- PMC5388443
- NLM abbreviation
- Am J Infect Control
- ISSN
- 0196-6553
- eISSN
- 1527-3296
- Publisher
- Elsevier Inc
- Number of pages
- 6
- Grant note
- K08GM109106-02 / National Institute of General Medical Sciences (http://dx.doi.org/10.13039/100000057) National Center for Advancing Translational Sciences (http://dx.doi.org/10.13039/100006108) UL1TR001111 / National Institutes of Health (http://dx.doi.org/10.13039/100000002)
- Language
- English
- Date published
- 12/01/2016
- Academic Unit
- Surgery
- Record Identifier
- 9984755396302771
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