Effect of bacteremia on mortality after thermal injury.

Infection is a common cause of death after thermal injury. Therefore, we reviewed the records of 1108 patients who had sustained burns to determine the effect of bacteremia on mortality. Overall, 32 patients died due to sepsis, 26 of whom had positive blood cultures. During this period, 93 patients had 133 bacteremic episodes. The 26 bacteremic patients (28%) who died had larger burns (71% +/- 24%) than the 67 patients who survived (39% +/- 24%), as well as a higher incidence of inhalation injuries. The patients dying of sepsis also were more likely to have polymicrobial bacteremias than the survivors. The distribution of microorganisms causing bacteremia was different between the surviving and nonsurviving patients, with patients sustaining fatal bacteremias having a higher incidence of infections with gram-negative enteric organisms or Pseudomonas. Thus, increased burn size and the presence of an inhalation injury, polymicrobial bacteremia, or gram-negative bacteremia were associated with an increased mortality rate in bacteremic patients with burns.