Burn-associated bloodstream infections in pediatric burn patients: Time distribution of etiologic agents.
BACKGROUND
Infections are the leading cause of morbidity and mortality in patients with burns in burn units. Bloodstream infections (BSIs) in patients with burns may result from burn wound infection, use of invasive devices such as central venous catheters, and translocation of the gastrointestinal flora.


OBJECTIVE
In this study, we investigated the distribution and antimicrobial drug resistance of causative pathogens in children with burns and the durational changes of microorganisms in the distribution of BSIs in children.


METHODS
This study was conducted at the Pediatric Burn Unit (PBU) of Dr. Behçet Uz Children Research and Training Hospital during the period of November 2008-April 2015. The study subjects were all the patients admitted to the PBU, in whom microorganisms were isolated at least from one of the cultures, including blood and catheter cultures.


RESULTS
Gram-positive bacteria were the most common causative agents of BSI in patients with burns (66.4%), followed by gram-negative bacteria (22.1%) and fungi (11.5%). The median duration of development of BSIs caused by gram-positive bacteria from the time of burn was 5 days (ranging from 2 to 54 days of burn), which was significantly shorter than that of BSIs caused by gram-negative bacteria (12 days) and fungal pathogens (13 days).


CONCLUSIONS
The etiologic agents of BSIs in children may differ from those in adults. Gram-negative drug-resistant bacteria such as multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were important agents of BSI in patients with burns, especially in the long term; however, gram-positive bacteria should also be considered while deciding the antimicrobial therapy, especially in the early periods of burn.
Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. Electronic address: ilkerdevrim2003@yahoo.com.
İlker
İ
Devrim
Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. Electronic address: ahukara01@hotmail.com.
Ahu
A
Kara
Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. Electronic address: mineduzgol@gmail.com.
Mine
M
Düzgöl
Department of Pediatric Surgery, Dr. Behçet Uz Children's Hospital, Izmir 35210, Turkey. Electronic address: drkarkiner@gmail.com.
Aytaç
A
Karkıner
Department of Pediatric Infectious Diseases, Dr. Behçet Uz Children's Hospital, İzmir, Turkey. Electronic address: nuribayram@gmail.com.
Nuri
N
Bayram
Department of Pediatric Surgery, Dr. Behçet Uz Children's Hospital, Izmir 35210, Turkey. Electronic address: drtemir@gmail.com.
Günyüz
G
Temir
Department of Pediatric Surgery, Dr. Behçet Uz Children's Hospital, Izmir 35210, Turkey. Electronic address: arzusencan71@yahoo.com.tr.
Arzu
A
Şencan
Department of Microbiology and Clinical Microbiology, Dr. Behçet Uz Children's Hospital, Izmir 35210, Turkey. Electronic address: yeldasorguc@hotmail.com.
Yelda
Y
Sorguç
Department of Microbiology and Clinical Microbiology, Dr. Behçet Uz Children's Hospital, Izmir 35210, Turkey. Electronic address: gamzegulfidan89@hotmail.com.
Gamze
G
Gülfidan
Department of Pediatric Surgery, Dr. Behçet Uz Children's Hospital, Izmir 35210, Turkey. Electronic address: munevver.hosgor@gmail.com.
Münevver
M
Hoşgör
D000151:Acinetobacter Infections / Q000453:epidemiology / Q000382:microbiology; D000293:Adolescent; D000890:Anti-Infective Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D002056:Burns / Q000453:epidemiology / Q000382:microbiology*; D002177:Candidiasis / Q000453:epidemiology / Q000382:microbiology*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology; D002405:Catheterization, Central Venous; D062905:Central Venous Catheters; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D016469:Fungemia / Q000453:epidemiology / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000382:microbiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology
D000890:Anti-Infective Agents
Burn; Burn-associated bloodstream infections; Children; Pediatric burn patients