title: Risk factors for central line-associated bloodstream infection in patients with major burns and the efficacy of the topical application of mupirocin at the central venous catheter exit site.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of the topical administration of mupirocin and other practices in central venous catheter (CVC) care to prevent central line-associated bloodstream infections (CLABSI) in patients with major burns.
  
  
  METHODS
  Patients with major burns admitted to a burn ICU were divided into four groups and disinfected at the CVC exit site with single povidone iodine (PVP-I) or PVP-I plus topical mupirocin ointment three times a day or once a day, respectively. The bacterial colonization of the skin at the CVC exit site and CVC tips and the incidence of CLABSI were recorded, and the risk factors were analyzed.
  
  
  RESULTS
  Administering mupirocin (RR=0.316, p=0.001), increasing the frequency of insertion-site care (RR=0.604, p=0.008), and avoiding cannulation at the burn site (RR=0.148, p<0.001) reduced skin colonization at the CVC insertion site. Topical administration of mupirocin significantly reduces both the bacterial colonization rate at CVC tips (RR=0.316, p=0.001) and the incidence of CLABSI (5.3 vs. 29.1 per 1000 catheter days, p<0.001).
  
  
  CONCLUSIONS
  Mupirocin is effective in the prophylaxis of CLABSI. Other CVC care practices were also found to affect the level of bacterial colonization, but their efficacy in preventing CLABSI needs to be evaluated further.
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.
authors.forename: Liju
authors.initials: L
authors.lastname: Tao
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China; Chongqing Key Laboratory for Proteomics of Diseases, Chongqing 400038, China.
authors.forename: Junyi
authors.initials: J
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.
authors.forename: Yali
authors.initials: Y
authors.lastname: Gong
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Long
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.
authors.forename: Xianhui
authors.initials: X
authors.lastname: Huang
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China; Chongqing Key Laboratory for Proteomics of Diseases, Chongqing 400038, China.
authors.forename: Gaoxing
authors.initials: G
authors.lastname: Luo
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China.
authors.forename: Yizhi
authors.initials: Y
authors.lastname: Peng
authors.affiliation: State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, Chongqing 400038, China; Chongqing Key Laboratory for Proteomics of Diseases, Chongqing 400038, China. Electronic address: editorinchief@burninchina.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
mesh_terms: D000151:Acinetobacter Infections / Q000453:epidemiology / Q000517:prevention & control; D000279:Administration, Cutaneous; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control*; D002053:Burn Units; D002056:Burns / Q000628:therapy*; D002353:Carrier State / Q000453:epidemiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control*; D062905:Central Venous Catheters; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000627:therapeutic use*; D011446:Prospective Studies; D065840:Protective Factors; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control; D015599:Trauma Severity Indices; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin
keywords: Burn; Catheter-associated bloodstream infection; Clinical care; Mupirocin