Öz
Infection is a major cause of morbidity and mortality
in burns patients. In spite of considerable advances in the treatment of burns,
infection continues to pose the greatest danger to burn patients. We
aimed to evaluate and present risk factors for multidrug resistant (MDR) Pseudomonas aeruginosa and Acinetobacter baumannii infections which
are considered as a challenge to burns.From January 2009 to May 2011, a total
of 465 patients hospitalized in Burn Care Unit were retrospectively reviewed
including bacteria isolated and antibiotic susceptibility tests.The mean age of
patients was 18.6 ±22.0 yr (median=6,1-87 yr). Use of invasive device, lenght
of stay in hospital, Intensive care unit lenght of stay and percentage of
Total Body Surface Area were statistically significant for MDR A. baumannii and P. aeruginosa. In logistic regression, length of stay and the
invasive device usage were found as risk factors for MDR A. baumannii and P. aeruginosa. Strict rules to control infections,
lower hospitalization period and reducing the invasive device usage are
essential to keep MDR and Nosocomial infections (NIs) rates lowered or
at least in a stable phase.
Anahtar Kelimeler
Kaynakça
- References1. Branski LK, Al-Mousawi A, Rivero H, Jeschke MG, Sanford AP, Herndon DN. Emerging infections in burns. Surg Infect. 2009; 10:389–97.
- 2. Keen EF, Robinson BJ, Hospenthal DR, et al. Incidence and bacteriology of burn infections at a military burn center. Burns 2010; 36:461-8.
- 3. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance defini- tion of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36:309-32.
- 4. American College of Surgeons. Advanced trauma life support.6th ed. Chicago: American College of Surgeons; 1997.
- 5. Lund CC, Browder NC. The estimation of areas of burns. Surg Gynecol Obstet 1944; 79:352-8.
- 6. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial disc susceptibility tests. CLSI Document M100-S12, 2002. CLSI, Wayne, PA.
- 7. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18:268–81.
- 8. Rafla K, Tredget E.E. Infection control in the burn unit. Burns 2011; 37:5-15.
- 9. Hand WL. Current challenges in antibiotic resistance. Adolescent Med. 2000; 11:427–38. 10. Alp E, Coruh A, Gunay GK, Yontar Y, Doganay M. Risk factors for nosocomial infection and mortality in burn patients: 10 years of experience at a university hospital. J Burn Care Res 2012; 33:379-85.
- 11. Oncül O, Ulkur E, Acar A, et al. Prospective analysis of nosocomial infections in a burn care unit, Turkey. Indian J Med Res 2009; 130:758-64.
- 12. Tekin R, Dal T, Bozkurt F, et al. Risk Factors for Nosocomial Burn Wound Infection Caused by Multidrug Resistant Acinetobacter baumannii. J Burn Care Res 2013; June 24
- 13. Jung JY1, Park MS, Kim SE, et al. Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit. BMC Infect Dis. 2010 Jul 30;10:228. doi: 10.1186/1471-2334-10-228.
- 14. Wong TH, Tan BH, Ling ML, Song C. Source. Multi-resistant Acinetobacter baumannii on a burns unit clinical risk factors and prognosis. BURNS;2002 Jun;28(4):349-57.
Yanık ünitesinde çoklu ilaç dirençli A. baumannii ve P. aeruginosa enfeksiyonlarında risk faktörleri
Öz
Yanık hastalarında enfeksiyon majör bir morbidite ve mortalite
sebebidir. Yanıklardaki tedavideki belirgin ilerlemelere rağmen enfeksiyon,
yanık hastalarına hala daha en büyük tehlike olmaya devam etmektedir.
Yanıklardaki en büyük zorluk olarak kabul edilen, çoklu ilaç dirençli (MDR) Pseudomonas aeruginosa ve Acinetobacter
baumannii enfeksiyonlarının risk faktörlerini değerlendirmeyi ve sunmayı
amaçladık. Ocak 2009’dan Mayıs 2011’e kadar Yanık Tedavi Ünitesinde yatan
toplam 465 hasta, izole edilen bakteriler ve antibiyotik duyarlılık testlerini
de içerecek şekilde retrospektif olarak değerlendirildi. Hastaların ortalama
yaşı 18.6 ±22.0 yr (median=6,1-87 yıl) idi. İnvaziv cihaz kullanımı, hastanede
kalış süresi, yoğun bakım ünitesinde kalış süresi ve yanık yüzey alanı yüzdesi,
MDR A. baumannii and P. aeruginosa için istatistiksel olarak
anlamlı bulundu. Lojistik regresyon analizine göre hastanede kalış süresi ve
invaziv cihaz kullanımı MDR A. baumannii
and P. aeruginosa enfeksiyonları için
risk faktörü olarak bulundu. Enfeksiyon kontrolünde katı kurallar, hastanede
kalış sürelerinin azaltılması ve invaziv cihaz kullanımının düşürülmesi MDR ve
hastane enfeksiyonu oranlarının azaltılması veya en azından sabit tutulması
yönünden elzemdir.
Anahtar Kelimeler
Kaynakça
- References1. Branski LK, Al-Mousawi A, Rivero H, Jeschke MG, Sanford AP, Herndon DN. Emerging infections in burns. Surg Infect. 2009; 10:389–97.
- 2. Keen EF, Robinson BJ, Hospenthal DR, et al. Incidence and bacteriology of burn infections at a military burn center. Burns 2010; 36:461-8.
- 3. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance defini- tion of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36:309-32.
- 4. American College of Surgeons. Advanced trauma life support.6th ed. Chicago: American College of Surgeons; 1997.
- 5. Lund CC, Browder NC. The estimation of areas of burns. Surg Gynecol Obstet 1944; 79:352-8.
- 6. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial disc susceptibility tests. CLSI Document M100-S12, 2002. CLSI, Wayne, PA.
- 7. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18:268–81.
- 8. Rafla K, Tredget E.E. Infection control in the burn unit. Burns 2011; 37:5-15.
- 9. Hand WL. Current challenges in antibiotic resistance. Adolescent Med. 2000; 11:427–38. 10. Alp E, Coruh A, Gunay GK, Yontar Y, Doganay M. Risk factors for nosocomial infection and mortality in burn patients: 10 years of experience at a university hospital. J Burn Care Res 2012; 33:379-85.
- 11. Oncül O, Ulkur E, Acar A, et al. Prospective analysis of nosocomial infections in a burn care unit, Turkey. Indian J Med Res 2009; 130:758-64.
- 12. Tekin R, Dal T, Bozkurt F, et al. Risk Factors for Nosocomial Burn Wound Infection Caused by Multidrug Resistant Acinetobacter baumannii. J Burn Care Res 2013; June 24
- 13. Jung JY1, Park MS, Kim SE, et al. Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit. BMC Infect Dis. 2010 Jul 30;10:228. doi: 10.1186/1471-2334-10-228.
- 14. Wong TH, Tan BH, Ling ML, Song C. Source. Multi-resistant Acinetobacter baumannii on a burns unit clinical risk factors and prognosis. BURNS;2002 Jun;28(4):349-57.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Dahili Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Mart 2019 |
| Kabul Tarihi | 18 Mart 2019 |
| Yayımlandığı Sayı | Yıl 2019 |