Risk factors for nosocomial burn wound infection caused by multidrug resistant Acinetobacter baumannii

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 evalu...

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Bibliographic Details
Published in:	Journal of burn care & research Vol. 35; no. 1; pp. e73 - e80
Main Authors:	Tekin, Recep, Dal, Tuba, Bozkurt, Fatma, Deveci, Ozcan, Palanc, Ylmaz, Arslan, Eyüp, Selçuk, Caferi Tayyar, Hoşoğlu, Salih
Format:	Journal Article
Language:	English
Published:	England 01-01-2014
Subjects:	Acinetobacter baumannii - isolation & purification Acinetobacter Infections - epidemiology Acinetobacter Infections - microbiology Acinetobacter Infections - therapy Anti-Bacterial Agents - therapeutic use APACHE Biopsy Burn Units Burns - microbiology Case-Control Studies Child Combined Modality Therapy Cross Infection - epidemiology Cross Infection - microbiology Cross Infection - therapy Drug Resistance, Multiple Female Humans Injury Severity Score Intensive Care Units - statistics & numerical data Length of Stay - statistics & numerical data Male Risk Factors Turkey - epidemiology Wound Infection - epidemiology Wound Infection - microbiology Wound Infection - therapy Turkey
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1559-047X 1559-0488
DOI:	10.1097/BCR.0b013e31828a493f