1. Microbiological findings in burn patients treated in a general versus a designated intensive care unit: Effect on length of stay.
- Author
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Issler-Fisher AC, Fakin RM, Fisher OM, McKew G, Gazzola R, Rauch AK, Gottlieb T, Haertsch P, Guggenheim M, Giovanoli P, and Maitz PK
- Subjects
- Adult, Bacteremia epidemiology, Bacteremia microbiology, Burns epidemiology, Candida albicans, Candidiasis epidemiology, Case-Control Studies, Catheter-Related Infections epidemiology, Catheter-Related Infections microbiology, Catheterization, Peripheral, Cross Infection epidemiology, Female, Humans, Length of Stay statistics & numerical data, Male, Middle Aged, New South Wales epidemiology, Pseudomonas Infections epidemiology, Pseudomonas aeruginosa, Respiratory Tract Infections epidemiology, Respiratory Tract Infections microbiology, Staphylococcal Infections epidemiology, Staphylococcus aureus, Urinary Tract Infections epidemiology, Urinary Tract Infections microbiology, Wound Infection epidemiology, Wound Infection microbiology, Burn Units, Burns microbiology, Candidiasis microbiology, Cross Infection microbiology, Drug Resistance, Microbial, Intensive Care Units, Pseudomonas Infections microbiology, Staphylococcal Infections microbiology
- Abstract
Background: Infection is one of the most common causes of mortality and morbidity in burn patients. The incidence and frequency of microbiological micro-organisms are known to vary across different models of intensive care units. To date, no study has attempted to describe the different findings in burn patients treated in an open, general intensive care unit (GICU) versus a dedicated burns intensive care unit (BICU). Only limited data is available on the effect of these microbiological micro-organisms on patients' length of stay., Aim: To characterize and compare the microbiological flora and antibiotic resistance patterns encountered in two different models of burn intensive care and to determine the effect of specific microbiological types on length of intensive care unit (ICU) and overall stay., Methods: A retrospective case-control study of 209 burn patients treated in two highly specialized, Western burn referral centres between September 2009 and March 2014., Results: 9710 culture results were analysed, of which 2590 (26.7%) yielded positive results (1537 in the GICU and 1050 in the BICU). Gram-positive cultures were more frequently found in the GICU, whereas Gram-negative and yeast cultures were more prevalent in the BICU. The most frequently encountered micro-organisms in both units were similar and included Staphylococcus aureus, Pseudomonas aeruginosa, coagulase-negative staphylococci (CoNS) and Candida albicans. Significantly more resistant bacteria were detected in the BICU. Testing positive across all types of microbiological isolates, as well as for both Gram-positive and -negative bacteria significantly prolonged patient length of stay. This effect was even more pronounced if the micro-organisms were resistant to antimicrobial therapy., Conclusion: There are notable differences in the microbiological isolate and antibiotic resistance patterns between burn patients treated in a GICU compared to a designated BICU. In both units, testing positive for resistant microbiological micro-organisms is significantly associated with longer hospital stay., (Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.)
- Published
- 2016
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