Evaluation of the Epidemiology, Risk Factors, Predictors and Fatality Associated with Extremely Drug-Resistant Infections in Burn Patients

• Published in: Ankara Ueniversitesi Tip Fakültesi mecmuasi Vol. 75; no. 2; pp. 211 - 218
• Main Authors: Erol, Çiğdem, Demirkaya, Melike Hamiyet, Gedik, Ender, Aydoğan, Cem, Arslan, Ayşe Hande, Haberal, Mehmet
• Format: Journal Article
• Language: English; Turkish
• Published: Ankara Galenos Publishing House 30.06.2022
• Subjects: Burns; Chronic illnesses; Drug resistance; Medical equipment
• ISSN: 1307-5608; 0365-8104; 1307-5608
• DOI: 10.4274/atfm.galenos.2022.97769

Objectives: Hospital-acquired infections are the leading causes of mortality in burn injuries following the initial resuscitation phase. Studies on healthcare associated antimicrobial-resistant infections in burn patients are limited. In this study, we aimed to evaluate the main risk factors and predictors of extremely drug-resistant infections in burn patients to highlight the need for optimal infection control approaches and antimicrobial stewardship. Materials and Methods: This retrospective case-control study enrolled 92 adult patients with burn injuries admitted to the burn care department of our hospital from January 2015 to December 2018. Results: Infection was observed in 47.8% of the burn patients (44/92), with 84 infection episodes noted among these patients. For the prediction of infection, only C-reactive protein/albumin ratio cut-off value was found to be a predictor after logistic regression analysis. Extremely drugresistant infections accounted for 27% (23/84) of the episodes in 14 patients. The most common site of these infections was the lower respiratory tract. Extremely drug-resistant bacteria were isolated from nearly 80% of the respiratory samples. Broad spectrum and multiple antimicrobial usage were independent risk factors for the development of extremely drug-resistant infections and the presence of the resistant infection was the only independent risk factor for fatality (p=0.001; odds ratio 10.4; 95% confidence interval 1,923-56,359). Conclusion: This study showed that extremely drug resistance was the major risk factor for fatality in burn patients. Infection control and antimicrobial stewardship programmes, which are crucial for limiting the development and spread of antimicrobial resistance, may decrease fatality in burn patients. We are able to cope with most of these factors with the infection control procedures.