[Typical bacteria in an intensive care burn unit in severely burned patients and their importance with regard to mortality: retrospective study 1995 - 2004].
The purpose of this study was to identify risk profiles for wound infection of severely burned patients in a retrospective analysis of patients of an intensive care burn unit during 1995 - 2004. The goal of this study was to identify risk factors on wound infection in severely burned patients. Possible influences on mortality were to be discussed. Inclusion criteria of the study population was a minimum age of 18 years and a body surface area burned of at least 40 % during the time period 1995 - 2004. 912 patients were screened and 96 patients were enrolled. Logistic regression was performed to investigate factors influencing wound infection and mortality in the study population. The initially detectable bacteria in the burn wounds were Staphylococcus aureus (21.1 %), Staphylococcus epidermidis (16.2 %) and Enterococcus faecalis (16.2 %). Of all swabs taken the most frequent initial discovered bacteria were Staphylococcus aureus (18.2 %), Staphylococcus epidermidis (12.7 %), Enterococcus faecalis (12.7 %) and Escherichia coli (13.3 %). The majority of positive swabs were the burn wound followed by nose and tracheal secretion. The risk of a wound infection was more likely in the period 2000 - 2004 in comparison to 1995 - 1999 with an Odds Ratio of 0.17 (95 % KI [0.05 - 0.63], p = 0.008). Wound infection was promoted by longer hospitalization on the burn intensive care unit with an Odds Ratio of 2.62 (95 % KI [1.34 - 5.11], p = 0.005) and by bacterial detection in the unburned parts of the body with an Odds Ratio of 5.36 (95 % KI [1.30 - 22.24], p = 0.02). Death was significantly promoted by age (over 50 years) with an Odds Ratio of 11.62 (95 % KI [2.76 - 48.92], p = 0.0008), wound infection with an Odds Ratio of 0.12 (95 % KI [0.03 - 0.52], p = 0.004) and inhalation injury with an Odds Ratio of 5.95 (95 % KI [1.72 - 20.55], p = 0.005). During the study period a rise of wound infections could be notified. Promoting factors were longer hospitalization on the burn intensive care unit and bacterial detection in the unburned parts of the body. Regarding mortality, higher age, wound infection and inhalation injury were prognostic factors.
Steinsträsser
L
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Klinik für Plastische Chirurgie und Schwerbrandverletzte, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Universität Bochum, Germany. lars.steinstraesser@ruhr-uni-bochum.de
Thies
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AH
Rabstein
S
S
Steinau
H-U
HU
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000382:microbiology* / Q000401:mortality; D002053:Burn Units; D002056:Burns / Q000382:microbiology* / Q000401:mortality; D003428:Cross Infection / Q000382:microbiology* / Q000401:mortality; D013293:Enterococcus faecalis; D004927:Escherichia coli Infections / Q000382:microbiology / Q000401:mortality; D005260:Female; D005858:Germany; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology / Q000401:mortality; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis; D016019:Survival Analysis; D014946:Wound Infection / Q000382:microbiology* / Q000401:mortality