Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study
•Most common isolates were Enterococcus sp., Candida sp. and Pseudomonas sp.•A greater TBSA and ABSI were associated with a higher incidence of BSIs.•The incidence of multidrug resistant (MDR) pathogens was relatively low.•MDR gram-negative BSI isolates were associated with increased mortality.•Burn...
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| Veröffentlicht in: | Burns 2018-06, Vol.44 (4), p.784-792 |
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| creator | Fochtmann-Frana, Alexandra Freystätter, Christian Vorstandlechner, Vera Barth, André Bolliger, Michael Presterl, Elisabeth Ihra, Gerald Muschitz, Gabriela Mittlboeck, Martina Makristathis, Athanasios Rath, Thomas Radtke, Christine Forstner, Christina |
| description | •Most common isolates were Enterococcus sp., Candida sp. and Pseudomonas sp.•A greater TBSA and ABSI were associated with a higher incidence of BSIs.•The incidence of multidrug resistant (MDR) pathogens was relatively low.•MDR gram-negative BSI isolates were associated with increased mortality.•Burn patients from abroad often suffered from BSI caused by MDR bacteria.
The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.
A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.
A total of 114 burn patients developed 171 episodes of BSIs caused by gram-negative bacteria (n=78;46%), gram-positive bacteria (n=69;40%), and fungi (n=24;14%) median after 14days (range, 1–164), 16days (range, 1–170), and 16days (range, 0–89), respectively. A total of 24/114 patients (21%) had fatal outcomes. Isolation of the most common bloodstream isolates Enterococcus sp. (n=26), followed by Candida sp. and Pseudomonas sp. (n=22 for both) was significantly associated with increased TBSA (p≤0.006) and ABSI (p |
| doi_str_mv | 10.1016/j.burns.2017.12.009 |
| format | Article |
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The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.
A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.
A total of 114 burn patients developed 171 episodes of BSIs caused by gram-negative bacteria (n=78;46%), gram-positive bacteria (n=69;40%), and fungi (n=24;14%) median after 14days (range, 1–164), 16days (range, 1–170), and 16days (range, 0–89), respectively. A total of 24/114 patients (21%) had fatal outcomes. Isolation of the most common bloodstream isolates Enterococcus sp. (n=26), followed by Candida sp. and Pseudomonas sp. (n=22 for both) was significantly associated with increased TBSA (p≤0.006) and ABSI (p<0.0001) and need for fasciotomy (p<0.01). The death risk of patients with MDR gram-negative bacteremia was significantly increased by a hazard ratio of 12.6 (95% CI:4.8–32.8; p<0.0001).
A greater TBSA and ABSI were associated with a significantly higher incidence of BSIs caused by Pseudomonas sp., Enterococcus sp. and Candida sp.</description><identifier>ISSN: 0305-4179</identifier><identifier>EISSN: 1879-1409</identifier><identifier>DOI: 10.1016/j.burns.2017.12.009</identifier><identifier>PMID: 29395408</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteremia - epidemiology ; Bacteremia - mortality ; Bloodstream infections among burn patients ; Body Surface Area ; Burn patients and septic complications ; Burn Units ; Burns - epidemiology ; Candidiasis - epidemiology ; Candidiasis - mortality ; Child ; Cohort Studies ; Critical Care ; Drug Resistance, Multiple, Bacterial ; Enterococcus ; Female ; Fungemia - epidemiology ; Fungemia - mortality ; Gram-Positive Bacterial Infections - epidemiology ; Gram-Positive Bacterial Infections - mortality ; Humans ; Incidence ; Male ; Middle Aged ; Multidrug resistant bacteria ; Proportional Hazards Models ; Pseudomonas Infections - epidemiology ; Pseudomonas Infections - mortality ; Retrospective Studies ; Risk Factors ; Severe burn injury ; Thermal injury ; Trauma Severity Indices ; Young Adult</subject><ispartof>Burns, 2018-06, Vol.44 (4), p.784-792</ispartof><rights>2018 Elsevier Ltd and ISBI</rights><rights>Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-a6af4cbb31031197d1f3c73c74889cc9e68541375c7ff6c807e56e10bc0c0da3</citedby><cites>FETCH-LOGICAL-c359t-a6af4cbb31031197d1f3c73c74889cc9e68541375c7ff6c807e56e10bc0c0da3</cites><orcidid>0000-0002-3144-7126 ; 0000-0003-1652-4856</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0305417917306782$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29395408$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fochtmann-Frana, Alexandra</creatorcontrib><creatorcontrib>Freystätter, Christian</creatorcontrib><creatorcontrib>Vorstandlechner, Vera</creatorcontrib><creatorcontrib>Barth, André</creatorcontrib><creatorcontrib>Bolliger, Michael</creatorcontrib><creatorcontrib>Presterl, Elisabeth</creatorcontrib><creatorcontrib>Ihra, Gerald</creatorcontrib><creatorcontrib>Muschitz, Gabriela</creatorcontrib><creatorcontrib>Mittlboeck, Martina</creatorcontrib><creatorcontrib>Makristathis, Athanasios</creatorcontrib><creatorcontrib>Rath, Thomas</creatorcontrib><creatorcontrib>Radtke, Christine</creatorcontrib><creatorcontrib>Forstner, Christina</creatorcontrib><title>Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study</title><title>Burns</title><addtitle>Burns</addtitle><description>•Most common isolates were Enterococcus sp., Candida sp. and Pseudomonas sp.•A greater TBSA and ABSI were associated with a higher incidence of BSIs.•The incidence of multidrug resistant (MDR) pathogens was relatively low.•MDR gram-negative BSI isolates were associated with increased mortality.•Burn patients from abroad often suffered from BSI caused by MDR bacteria.
The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.
A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.
A total of 114 burn patients developed 171 episodes of BSIs caused by gram-negative bacteria (n=78;46%), gram-positive bacteria (n=69;40%), and fungi (n=24;14%) median after 14days (range, 1–164), 16days (range, 1–170), and 16days (range, 0–89), respectively. A total of 24/114 patients (21%) had fatal outcomes. Isolation of the most common bloodstream isolates Enterococcus sp. (n=26), followed by Candida sp. and Pseudomonas sp. (n=22 for both) was significantly associated with increased TBSA (p≤0.006) and ABSI (p<0.0001) and need for fasciotomy (p<0.01). The death risk of patients with MDR gram-negative bacteremia was significantly increased by a hazard ratio of 12.6 (95% CI:4.8–32.8; p<0.0001).
A greater TBSA and ABSI were associated with a significantly higher incidence of BSIs caused by Pseudomonas sp., Enterococcus sp. and Candida sp.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - mortality</subject><subject>Bloodstream infections among burn patients</subject><subject>Body Surface Area</subject><subject>Burn patients and septic complications</subject><subject>Burn Units</subject><subject>Burns - epidemiology</subject><subject>Candidiasis - epidemiology</subject><subject>Candidiasis - mortality</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Critical Care</subject><subject>Drug Resistance, Multiple, Bacterial</subject><subject>Enterococcus</subject><subject>Female</subject><subject>Fungemia - epidemiology</subject><subject>Fungemia - mortality</subject><subject>Gram-Positive Bacterial Infections - epidemiology</subject><subject>Gram-Positive Bacterial Infections - mortality</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multidrug resistant bacteria</subject><subject>Proportional Hazards Models</subject><subject>Pseudomonas Infections - epidemiology</subject><subject>Pseudomonas Infections - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severe burn injury</subject><subject>Thermal injury</subject><subject>Trauma Severity Indices</subject><subject>Young Adult</subject><issn>0305-4179</issn><issn>1879-1409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxi1ERZctT4CEfOSSYK_zz0gcqqotlSpx6d1yJmPqJYkXj7OoL8Lz4nQLRyxLHtm_-cYzH2PvpSilkM2nfdkvcaZyJ2Rbyl0phH7FNrJrdSEroV-zjVCiLirZ6nP2lmgv8qo78Yad77TSdSW6Dft9N4MfcAbkwfHo6Qd3FlKIxF2IvB9DGChFtBP3s0NIPsyUQ36wyeOciP_y6ZFPdr_S6394REB_9PP3jCWcyR-Rg434mV_mtxQDHVadfEsZGrGArIORQ3gMMXFKy_B0wc6cHQnfvZxb9nBz_XD1tbj_dnt3dXlfgKp1KmxjXQV9r6RQUup2kE5Bm3fVdRpAY9PVlVRtDa1zDXSixbpBKXoQIAartuzjSfYQw88FKZnJE-A42hnDQkbqPChdyyy_ZeqEQm6AIjpziH6y8clIYVY_zN48929WP4zcmexHzvrwUmDpJxz-5fw1IANfTgDmLo8eoyHwqx2Dz3NMZgj-vwX-AAFUoUY</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Fochtmann-Frana, Alexandra</creator><creator>Freystätter, Christian</creator><creator>Vorstandlechner, Vera</creator><creator>Barth, André</creator><creator>Bolliger, Michael</creator><creator>Presterl, Elisabeth</creator><creator>Ihra, Gerald</creator><creator>Muschitz, Gabriela</creator><creator>Mittlboeck, Martina</creator><creator>Makristathis, Athanasios</creator><creator>Rath, Thomas</creator><creator>Radtke, Christine</creator><creator>Forstner, Christina</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3144-7126</orcidid><orcidid>https://orcid.org/0000-0003-1652-4856</orcidid></search><sort><creationdate>201806</creationdate><title>Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study</title><author>Fochtmann-Frana, Alexandra ; Freystätter, Christian ; Vorstandlechner, Vera ; Barth, André ; Bolliger, Michael ; Presterl, Elisabeth ; Ihra, Gerald ; Muschitz, Gabriela ; Mittlboeck, Martina ; Makristathis, Athanasios ; Rath, Thomas ; Radtke, Christine ; Forstner, Christina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-a6af4cbb31031197d1f3c73c74889cc9e68541375c7ff6c807e56e10bc0c0da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bacteremia - epidemiology</topic><topic>Bacteremia - mortality</topic><topic>Bloodstream infections among burn patients</topic><topic>Body Surface Area</topic><topic>Burn patients and septic complications</topic><topic>Burn Units</topic><topic>Burns - epidemiology</topic><topic>Candidiasis - epidemiology</topic><topic>Candidiasis - mortality</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Critical Care</topic><topic>Drug Resistance, Multiple, Bacterial</topic><topic>Enterococcus</topic><topic>Female</topic><topic>Fungemia - epidemiology</topic><topic>Fungemia - mortality</topic><topic>Gram-Positive Bacterial Infections - epidemiology</topic><topic>Gram-Positive Bacterial Infections - mortality</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multidrug resistant bacteria</topic><topic>Proportional Hazards Models</topic><topic>Pseudomonas Infections - epidemiology</topic><topic>Pseudomonas Infections - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severe burn injury</topic><topic>Thermal injury</topic><topic>Trauma Severity Indices</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fochtmann-Frana, Alexandra</creatorcontrib><creatorcontrib>Freystätter, Christian</creatorcontrib><creatorcontrib>Vorstandlechner, Vera</creatorcontrib><creatorcontrib>Barth, André</creatorcontrib><creatorcontrib>Bolliger, Michael</creatorcontrib><creatorcontrib>Presterl, Elisabeth</creatorcontrib><creatorcontrib>Ihra, Gerald</creatorcontrib><creatorcontrib>Muschitz, Gabriela</creatorcontrib><creatorcontrib>Mittlboeck, Martina</creatorcontrib><creatorcontrib>Makristathis, Athanasios</creatorcontrib><creatorcontrib>Rath, Thomas</creatorcontrib><creatorcontrib>Radtke, Christine</creatorcontrib><creatorcontrib>Forstner, Christina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Burns</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fochtmann-Frana, Alexandra</au><au>Freystätter, Christian</au><au>Vorstandlechner, Vera</au><au>Barth, André</au><au>Bolliger, Michael</au><au>Presterl, Elisabeth</au><au>Ihra, Gerald</au><au>Muschitz, Gabriela</au><au>Mittlboeck, Martina</au><au>Makristathis, Athanasios</au><au>Rath, Thomas</au><au>Radtke, Christine</au><au>Forstner, Christina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study</atitle><jtitle>Burns</jtitle><addtitle>Burns</addtitle><date>2018-06</date><risdate>2018</risdate><volume>44</volume><issue>4</issue><spage>784</spage><epage>792</epage><pages>784-792</pages><issn>0305-4179</issn><eissn>1879-1409</eissn><abstract>•Most common isolates were Enterococcus sp., Candida sp. and Pseudomonas sp.•A greater TBSA and ABSI were associated with a higher incidence of BSIs.•The incidence of multidrug resistant (MDR) pathogens was relatively low.•MDR gram-negative BSI isolates were associated with increased mortality.•Burn patients from abroad often suffered from BSI caused by MDR bacteria.
The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.
A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.
A total of 114 burn patients developed 171 episodes of BSIs caused by gram-negative bacteria (n=78;46%), gram-positive bacteria (n=69;40%), and fungi (n=24;14%) median after 14days (range, 1–164), 16days (range, 1–170), and 16days (range, 0–89), respectively. A total of 24/114 patients (21%) had fatal outcomes. Isolation of the most common bloodstream isolates Enterococcus sp. (n=26), followed by Candida sp. and Pseudomonas sp. (n=22 for both) was significantly associated with increased TBSA (p≤0.006) and ABSI (p<0.0001) and need for fasciotomy (p<0.01). The death risk of patients with MDR gram-negative bacteremia was significantly increased by a hazard ratio of 12.6 (95% CI:4.8–32.8; p<0.0001).
A greater TBSA and ABSI were associated with a significantly higher incidence of BSIs caused by Pseudomonas sp., Enterococcus sp. and Candida sp.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>29395408</pmid><doi>10.1016/j.burns.2017.12.009</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3144-7126</orcidid><orcidid>https://orcid.org/0000-0003-1652-4856</orcidid></addata></record> |
| fulltext | fulltext |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Bacteremia - epidemiology Bacteremia - mortality Bloodstream infections among burn patients Body Surface Area Burn patients and septic complications Burn Units Burns - epidemiology Candidiasis - epidemiology Candidiasis - mortality Child Cohort Studies Critical Care Drug Resistance, Multiple, Bacterial Enterococcus Female Fungemia - epidemiology Fungemia - mortality Gram-Positive Bacterial Infections - epidemiology Gram-Positive Bacterial Infections - mortality Humans Incidence Male Middle Aged Multidrug resistant bacteria Proportional Hazards Models Pseudomonas Infections - epidemiology Pseudomonas Infections - mortality Retrospective Studies Risk Factors Severe burn injury Thermal injury Trauma Severity Indices Young Adult |
| title | Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study |
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