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- Alexandra Fochtmann-Frana, Christian Freystätter, Vera Vorstandlechner, André Barth, Michael Bolliger, Elisabeth Presterl, Gerald Ihra, Gabriela Muschitz, Martina Mittlboeck, Athanasios Makristathis, Thomas Rath, Christine Radtke, and Christina Forstner.
- Medical University of Vienna, Clinical Division of Plastic and Reconstructive Surgery, Department of Surgery, Vienna, Austria. Electronic address: alexandra.fochtmann-frana@meduniwien.ac.at.
- Burns. 2018 Jun 1; 44 (4): 784-792.
ObjectivesThe objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.MethodsA 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.ResultsA 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).ConclusionsA greater TBSA and ABSI were associated with a significantly higher incidence of BSIs caused by Pseudomonas sp., Enterococcus sp. and Candida sp.Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.
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