Epidemiology of bloodstream infections in burn-injured patients: A review of the national burn repository

Jeffrey W. Shupp, Anna R. Pavlovich, James C. Jeng, John C. Pezzullo, William J. Oetgen, Amin D. Jaskille, Marion H. Jordan, Shmuel Shoham

Research output: Contribution to journalArticle

Abstract

Bloodstream infections (BSIs) are a major cause of morbidity and mortality in thermally injured patients. However, these infections have not been well defined in this patient population. Therefore, the authors performed a retrospective case-control study to characterize the epidemiology, microbiology, and outcomes of burn-associated BSIs. A retrospective review of all patients in the National Burn Repository (NBR) between the years 1981 and 2007 was performed. All cases that had infection listed under complications were included in this study. For each case, two randomly selected patients from the same time period served as controls. Patient demographic data, extent of %TBSA, and type of infection were extracted. Primary end point was mortality. Secondary endpoints were hospital length of stay (LOS), intensive care unit LOS, total ventilator days, and hospital charges. Further analysis of the data involved case-matching patients by TBSA deciles, adjustment for the effects of TBSA and other potential confounders, and a sensitivity analysis of the effects of including or excluding sites that might have failed to consistently capture BSI information. A total of 11,793 patients (3931 cases and 7862 control) were included in the study. Of cultures revealing a Gram-positive organism, Staphylococcus aureus (32%) was the most common. From samples where isolation of a Gram-negative species occurred, Pseudomonas aeruginosa (35%) was more prominent. Infected patients were older (40.9 vs 32.8, P <.05) and had higher %TBSA (22.2 vs 7.9, P <.05). BSI was associated with significantly higher mortality (21.9% vs 3.09%), hospital LOS (47.4 vs 8.8 days) intensive care unit LOS (30.8 vs 2.6 days), ventilator days (29.2 vs 1.4 days), and hospital charge ($339,909.91 vs $33,272.43); P <.001 for all values. On evaluation of case-matched controls, mortality was higher for patients with BSI only

Original languageEnglish (US)
Pages (from-to)521-528
Number of pages8
JournalJournal of Burn Care and Research
Volume31
Issue number4
DOIs
StatePublished - Jul 2010
Externally publishedYes

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Burns
Epidemiology
Length of Stay
Infection
Hospital Charges
Mortality
Mechanical Ventilators
Intensive Care Units
Microbiology
Pseudomonas aeruginosa
Staphylococcus aureus
Case-Control Studies
Demography
Morbidity
Population

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

Epidemiology of bloodstream infections in burn-injured patients : A review of the national burn repository. / Shupp, Jeffrey W.; Pavlovich, Anna R.; Jeng, James C.; Pezzullo, John C.; Oetgen, William J.; Jaskille, Amin D.; Jordan, Marion H.; Shoham, Shmuel.

In: Journal of Burn Care and Research, Vol. 31, No. 4, 07.2010, p. 521-528.

Research output: Contribution to journalArticle

Shupp, Jeffrey W. ; Pavlovich, Anna R. ; Jeng, James C. ; Pezzullo, John C. ; Oetgen, William J. ; Jaskille, Amin D. ; Jordan, Marion H. ; Shoham, Shmuel. / Epidemiology of bloodstream infections in burn-injured patients : A review of the national burn repository. In: Journal of Burn Care and Research. 2010 ; Vol. 31, No. 4. pp. 521-528.
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