Risk Factors for Nosocomial Burn Wound Infection Caused by Multidrug Resistant Acinetobacter baumannii

Abstract

Acinetobacter baumannii infections in burn patients may lead to delays in wound healing, graft losses, and development of sepsis. Determining the risk factors for multidrug resistant A. baumannii (MDR-AB) infections is essential for infection control. In the present study, the authors aimed to evaluate risk factors for wound infections caused by A. baumannii in burn patients. The study was conducted at Dicle University Hospital Burn Center, from April 2011 to July 2012, to investigate the risk factors for MDR-AB infections. The data of both the case and control group patients and the result of wound cultures were recorded on a daily basis, on individual forms given for each patient, and analyzed. A total of 30 cases infected with MDR-AB, and 60 uninfected control patients, were included in the study. The mean age (±SD) was 7.7 ± 15.4 years in infected patients and 11.4 ± 16.5 years in uninfected patients. The mean total burn surface area was 13.5 ± 10.9% in uninfected patients and 34.7 ± 16.2% in infected patients. The mean total burn surface area, the abbreviated burn severity index, acute physiological and chronic health evaluation II score, day of admission to hospital, length of hospital stay, first excision day, prior usage of third-generation cephalosporins, and stay in intensive care unit of the infected patients were significantly higher (P < .001) than those of patients without infection. Univariate analysis found that high acute physiological and chronic health evaluation II score, first excision time of wound, invasive device usage, admission day to hospital, and prior usage of broad-spectrum antibiotics were risk factors for nosocomial infections. This study showed that multiple factors contribute to multidrug resistance in A. baumannii. A combination of an early diagnosis of wound infections, appropriate antimicrobial treatments, surgical debridement, and early wound closure may be effective in the management.

Prevalence of aerobic pathogenic bacteria isolated from patients with burn infection and their antimicrobial susceptibility patterns in Al-Najaf City, Iraq- a three-year cross-sectional study.

“…P. aeruginosa was the most common PDR-bacteria followed by MRSA and A.baumannii. These results are similar with many previous studies 5, [45][46][47] . Biofilm formation by microorganisms is one of the most important mechanisms in antimicrobials resistant, consisting of the irreversible assemblage of bacterial cells associated with a surface and enclosed in matrix of polysaccharides material 48 .…”

“…The overuse and unsuitability of different antimicrobials to treat burn infections has led to the emergence of new MDR, XDR and PDR-bacterial strains that are able to resistant a wide range of many antimicrobials such as aminoglycosides, beta-lactams, cephalosporins, streptomycin and tetracycline 49,50 . Burn infection in hospitalized patients caused by MDR, XDR and PDR-gram negative and gram positive bacteria such as; P. aeruginosa, K. pneumoniae, MRSA, MSSA and A.baumannii may lead to delays in burn healing, graft lose, as well as development of sepsis and death; therefore, determination of the risk factors for these pathogens infections is essential for infection control 47 . The results of this study showed that P. aeruginosa and K. pneumoniae were the most common ESBLproducing gram negative bacteria followed by A.baumannii and E.coli while there was no any strain of ESBL-S.typhi.…”

Trends in microbial profile of burn patients following an event of dust explosion at a tertiary medical center

“…Due to the fact that subjects in this study belonged to a young and homogeneous group, of particular interest to us was the influence of both burn severity and time factor on the types of microbial isolates. Several multivariate analyses of prospective or retrospective studies have revealed that the degree of burn wounds was a major risk factor for microbial colonization and infection [1,5,7,26]. Compared to ≤19% of TBSA, patients with greater than 20% of TBSA were more than twice (RR 2.09-2.41) likely to be infected at a rate that was five times faster [7].…”

Risk Factors for Bloodstream Infections Due to Acinetobacter spp.: A Prospective Case-Control Study

“…Hastane kaynaklı Acinetobacter infeksiyonları genellikle geç edinilmektedir ve çeşitli çalışmalarda, yatış süresinin daha uzun olduğu saptanmıştır (15,16). Sunulan çalışmada da, tek değişkenli analizde, yatış süresi olgu grubunda kontrol gruplarına göre daha uzun bulunmuştur (p=0.005).…”