BACKGROUND: Bloodstream infections are common in burn patients. OBJECTIVE: To evaluate the effects of bloodstream infections in patients with severe burn injuries. METHODS: A retrospective, pairwise-matched, risk-adjusted cohort study in a 6-bed burn unit was done. "Exposed" patients with microbiological evidence of bloodstream infections (n = 76) were compared with nonexposed patients (n = 103) matched for burn severity (identical Belgian Outcome in Burn Injury score) and length of hospitalization (≥time-to-event in exposed patients). Main outcome measures were length of hospitalization and mortality. RESULTS: Predominant pathogens were Staphylococcus aureus, enterococci, Pseudomonas aeruginosa, Escherichia coli, coagulase-negative staphylococci, and Candida species. Median patient age was 42 years (interquartile range [IQR], 31-52). Median total burned surface area was 40% (IQR, 25%-50%). Inhalation injury occurred in 54%. Median burn injury score was 4 (IQR, 2-5). Median length of stay before onset of bacteremia was 11 days (IQR, 5.3-19.8). Appropriate antimicrobial therapy was initiated within the first 48 hours in 76%. The exposed group had a higher need for vasopressive/inotropic support (P = .02); need for ventilatory assistance and renal replacement therapy did not differ significantly between groups. Hospital mortality did not differ (P = .30). However, bloodstream infection was associated with longer durations of hospitalization (P < .001) and mechanical ventilation (P < .001). CONCLUSIONS: In this cohort of burn patients, bloodstream infections did not adversely affect survival, but greater durations of ventilator dependency and hospital stay increased costs of care.
BACKGROUND:Bloodstream infections are common in burn patients. OBJECTIVE: To evaluate the effects of bloodstream infections in patients with severe burn injuries. METHODS: A retrospective, pairwise-matched, risk-adjusted cohort study in a 6-bed burn unit was done. "Exposed" patients with microbiological evidence of bloodstream infections (n = 76) were compared with nonexposed patients (n = 103) matched for burn severity (identical Belgian Outcome in Burn Injury score) and length of hospitalization (≥time-to-event in exposed patients). Main outcome measures were length of hospitalization and mortality. RESULTS: Predominant pathogens were Staphylococcus aureus, enterococci, Pseudomonas aeruginosa, Escherichia coli, coagulase-negative staphylococci, and Candida species. Median patient age was 42 years (interquartile range [IQR], 31-52). Median total burned surface area was 40% (IQR, 25%-50%). Inhalation injury occurred in 54%. Median burn injury score was 4 (IQR, 2-5). Median length of stay before onset of bacteremia was 11 days (IQR, 5.3-19.8). Appropriate antimicrobial therapy was initiated within the first 48 hours in 76%. The exposed group had a higher need for vasopressive/inotropic support (P = .02); need for ventilatory assistance and renal replacement therapy did not differ significantly between groups. Hospital mortality did not differ (P = .30). However, bloodstream infection was associated with longer durations of hospitalization (P < .001) and mechanical ventilation (P < .001). CONCLUSIONS: In this cohort of burn patients, bloodstream infections did not adversely affect survival, but greater durations of ventilator dependency and hospital stay increased costs of care.
Authors: Ilse van Langeveld; Robin C Gagnon; Peggie F Conrad; Richard L Gamelli; Brendan Martin; Mashkoor A Choudhry; Michael J Mosier Journal: J Burn Care Res Date: 2017 Mar/Apr Impact factor: 1.845
Authors: Thomas Secher; Stefanie Fas; Louis Fauconnier; Marieke Mathieu; Oliver Rutschi; Bernhard Ryffel; Michael Rudolf Journal: PLoS One Date: 2013-09-02 Impact factor: 3.240