Citation

Lin TC, Wu RX, Chiu CC, Yang YS, Lee Y, Lin JC, Chang FY. J. Microbiol. Immunol. Infect. 2018; 51(2): 267-277.

Affiliation

Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: fychang@ndmctsgh.edu.tw.

Copyright

(Copyright © 2018, Taiwan Society of Microbiology, Publisher Elsevier Publishing)

DOI

10.1016/j.jmii.2016.08.019

PMID

28705768

Abstract

BACKGROUND/PURPOSE: Bloodstream infection is a leading cause of mortality among burn patients. This study aimed to evaluate the risk factors, causative pathogens, and the relationship between bloodstream infections and other infections among burn patients from the Formosa Fun Coast Dust Explosion.

METHODS: This retrospective study evaluated the demographic and clinical characteristics, infection types, causative pathogen(s), and isolates' antibiotic susceptibilities from patients who were hospitalized between June 27 and September 31, 2015.

RESULTS: Fifty-eight patients were admitted during the study period (36 males, mean age: 22.6 years). The mean burned total body surface area (TBSA) was 40% for all patients. Eighteen (31%) patients with mean TBSA of 80% had 66 episodes of bloodstream infections caused by 92 isolates. Twelve (18.2%) episodes of bloodstream infections were polymicrobial. Acinetobacter baumannii (19, 20.7%), Ralstonia pickettii (17, 18.5%), and Chryseobacterium meningosepticum (13, 14.1%) were the most common pathogens causing bloodstream infections. A high concordance rate of wound cultures with blood cultures was seen in Staphylococcus aureus (3, 75%) and C. meningosepticum (8, 61.5%) infections. However, no Ralstonia isolate was found in burn wounds of patients with Ralstonia bacteremia. A high concordance rate of central venous catheter cultures with blood cultures was noted in Ralstoniamannitolilytica (5, 62.5%) and Chryseobacteriumindologenes (3, 60%) infections. Approximately 21.1% of A. baumannii strains were resistant to carbapenem. All S. aureus isolates were susceptible to methicillin.

CONCLUSIONS: Waterborne bacteria should be considered in patients of burns with possible water contact. Empirical broad-spectrum antibiotics should be considered for patients who were hospitalized for severe sepsis, or septic shock with a large burn. Antibiotic treatment should be administered based on the specific pathogens and their detection points.

Copyright © 2017. Published by Elsevier B.V.

Language: en

Keywords

Bacteremia; Burn injury; Formosa Fun Coast Dust Explosion; Gram-negative bacteria; Resistance