• Andrea C Issler-Fisher, Genevieve McKew, Oliver M Fisher, Varun Harish, Thomas Gottlieb, and Peter K M Maitz.
• Burns Unit, Concord Repatriation General Hospital, Sydney, Australia. Electronic address: andrea.issler@gmail.com.
• Burns. 2015 Sep 1; 41 (6): 1212-20.

BackgroundMRSA is an on-going problem for burn patients.AimTo analyze risk factors for, and the effect of MRSA colonization on burn patients' outcome.MethodsDuring 21 months burn patients' details and MRSA isolates were analyzed, and a case-control study performed.ResultsOf 357 burn patients, 57 (16%) tested positive for MRSA. Compared to the MRSA negative group, MRSA positive patients had a higher median total burn surface area (15%[IQR 5-17%] vs. 5%[IQR 2-8%]; p<0.001), more admissions to ICU (54% vs. 26%; p<0.001), longer ICU length of stay (4.3 vs. 1.0 days; p<0.001), required more operations (1.6 vs. 0.8; p<0.001), and had longer total hospital length of stay (25.5 vs. 8.0 days; p<0.001). MRSA positivity was a significant independent predictor of increased length of stay (6.0 days, 95%CI 2.39-9.6 days; p=0.001) in a multivariable regression model correcting for patients TBSA and co-morbidities. Cardiac comorbidities (OR 5.14, 95%CI 1.76-15.62; p<0.001) and a longer exposure to the hospital environment (OR 1.05, 95%CI 1.02-1.09, p=0.005) increased the likelihood for MRSA positivity.ConclusionThe negative impact of MRSA positivity on burn patients outcome indicates the need for improved screening procedures for early identification and further efforts toward MRSA infection control to prevent cross-infection as this may significantly impair patients' outcome.Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

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