Multiresistant Acinetobacter spp in a burn unit in Argentina

Abstract

Background: Multiresistant Acinetobacter spp has emerged as an important microorganisms in critical areas like burn units.Objetives: Infections caused by multiple drug resistant (MDR) Acinetobacter spp was studied in our burn unit to evaluate epidemiological, clinical features, outcome, use of colistin and adverse effects related with this antibiotic.Methods: A prospective chart review of pediatric patients admitted to our tertiary burn unit between January 2005 and December 2006 with isolation of multiresistant Acynetobacter spp was performed. During the study period, 26 p were evaluated with isolation of Acinetobacter spp.Results: The mean age of the patients was 66.5 months (range: 2 to 168 m), 17 patients (65%) were male. The burnt surface was between 10% and 87% (median 42.5%). Full thickness was present in 10 p (39%). Burn wound sepsis was the most frequent focus in 10 patients (39%). In 8 patients (30%), burn wound infection occurred without sepsis. Intravascular catheter-related bacteremia was found in three patients (11%) and bacteremia in one (4%). Two patients had pneumonia (8%), and two urinary tract infection (8%). All patients were treated with colistin.according susceptibility test. The time of colistin treatment was between 10 and 71 days (median 21days). None of the children developed adverse effects attributable to colistin. The outcome was favorable in all patients.Conclusion: Multiresistant Acinetobacter spp has emerged as a new threat in burn units. Burn wound sepsis was the most common foci. Colistin was a safe drug for the treatment. The outcome was favorable in all patients.

Risk factors for mortality in burn children

“…Mortality rates reported in literature are lower than the rate found in our study, 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 but a limitation of the present report is that the data were collected in a national tertiary referral center which may have caused patient selection bias, including a higher proportion of critically ill e patients.…”

“…and P. aeruginosa have emerged as important microorganisms in critical areas like burn units and are related with increased mortality in these areas. 19 , 20 , 21 …”

“…Fungal infection, not colonization, has been recognized as an important cause of morbidity and mortality in burn patients. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 However, fungal infection appears in more severely injured patients with the high percentage of burned body surface, and if the wounds remained opened for prolonged periods, the use of antibiotics and long hospital stay could be related with the propensity to acquire fungal infections. 24 The use of antifungal drugs was a predictor of poor outcome in our patients by univariate analysis, but not in multivariate analysis.…”