Prospective Analysis of Nosocomial Infection Rates, Antibiotic Use, and Patterns of Resistance in a Burn Population (original) (raw)

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*Department of Surgery, The University of Iowa Carver College of Medicine, Iowa City

**Address correspondence to Lucy Wibbenmeyer, MD, The University of Iowa Carver College of Medicine, 200 Hawkins Drive, Department of Surgery, Iowa City, Iowa 52246.

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†Department of Surgery, University of Kansas, Kansas City

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‡Department of Surgery, University of Wisconsin, Madison

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§Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City

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*Department of Surgery, The University of Iowa Carver College of Medicine, Iowa City

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*Department of Surgery, The University of Iowa Carver College of Medicine, Iowa City

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§Department of Internal Medicine, The University of Iowa Carver College of Medicine, Iowa City

¶Clinical Outcomes and Resource Management, The University of Iowa Hospitals and Clinics, Iowa City

‖The Department of Epidemiology, the University of Iowa College of Public Health, Iowa City

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Lucy Wibbenmeyer, Roy Danks, Lee Faucher, Marge Amelon, Barbara Latenser, G Patrick Kealey, Loreen A. Herwaldt, Prospective Analysis of Nosocomial Infection Rates, Antibiotic Use, and Patterns of Resistance in a Burn Population, Journal of Burn Care & Research, Volume 27, Issue 2, March-April 2006, Pages 152–160, https://doi.org/10.1097/01.BCR.0000203359.32756.F7
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Abstract

Despite significant advances in burn care, infection remains a major cause of morbidity and mortality in burn patients. We sought to determine accurate infection rates, risk factors for infection, and the percentage of infections caused by resistant organisms. In addition, we attempted to identify interventions to decrease the use of antimicrobial drugs. Data were collected prospectively from 157 burn patients admitted to the University of Iowa Carver College of Medicine burn treatment center from October 2001 to October 2002. A research assistant reviewed the medical record for each patient identified by burn surgeons as being infected to determine whether these episodes met the infection control criteria for nosocomial infections. The infection control assessment agreed with the surgeon′s assessment for 16.7% of the pneumonias, 70.0% of the burn wound infections, 57.1% of the urinary tract infections, and 70.0% of the bloodstream infections. By multiple logistic regression analysis, body surface area burned, comorbidities, and use of invasive devices were significantly related to acquisition of nosocomial infections as identified by both the burn surgeons and the infection control criteria. Staphylococcus aureus and Pseudomonas were the most common resistant organisms identified. In our population, surgeons could decrease antimicrobial use by using explicit criteria for identifying patients with hospital-acquired infections, limiting perioperative prophylaxis to patients at highest risk of infection, and decreasing the incidence of nosocomial infection with reduced use of devices and strict adherence to aseptic technique.

Copyright © 2006 by the American Burn Association

Topic:

• burn infections
• urinary tract infections
• burn units
• burns
• infectious disease prevention / control
• pneumonia
• infections
• nosocomial infection
• antimicrobials
• bloodstream infections

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