The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion
Background/Purpose: Bloodstream infection is a leading cause of mortality among burn patients. This study aimed to evaluate the risk factors, causative pathogens, and the relationship between bloodstream infections and other infections among burn patients from the Formosa Fun Coast Dust Explosion. M...
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Elsevier
2018-04-01
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Series: | Journal of Microbiology, Immunology and Infection |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1684118217300622 |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tzu-Chao Lin Rui-Xin Wu Chih-Chien Chiu Ya-Sung Yang Yi Lee Jung-Chung Lin Feng-Yee Chang |
spellingShingle |
Tzu-Chao Lin Rui-Xin Wu Chih-Chien Chiu Ya-Sung Yang Yi Lee Jung-Chung Lin Feng-Yee Chang The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion Journal of Microbiology, Immunology and Infection |
author_facet |
Tzu-Chao Lin Rui-Xin Wu Chih-Chien Chiu Ya-Sung Yang Yi Lee Jung-Chung Lin Feng-Yee Chang |
author_sort |
Tzu-Chao Lin |
title |
The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion |
title_short |
The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion |
title_full |
The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion |
title_fullStr |
The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion |
title_full_unstemmed |
The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust Explosion |
title_sort |
clinical and microbiological characteristics of infections in burn patients from the formosa fun coast dust explosion |
publisher |
Elsevier |
series |
Journal of Microbiology, Immunology and Infection |
issn |
1684-1182 |
publishDate |
2018-04-01 |
description |
Background/Purpose: Bloodstream infection is a leading cause of mortality among burn patients. This study aimed to evaluate the risk factors, causative pathogens, and the relationship between bloodstream infections and other infections among burn patients from the Formosa Fun Coast Dust Explosion. Methods: This retrospective study evaluated the demographic and clinical characteristics, infection types, causative pathogen(s), and isolates' antibiotic susceptibilities from patients who were hospitalized between June 27 and September 31, 2015. Results: Fifty-eight patients were admitted during the study period (36 males, mean age: 22.6 years). The mean burned total body surface area (TBSA) was 40% for all patients. Eighteen (31%) patients with mean TBSA of 80% had 66 episodes of bloodstream infections caused by 92 isolates. Twelve (18.2%) episodes of bloodstream infections were polymicrobial. Acinetobacter baumannii (19, 20.7%), Ralstonia pickettii (17, 18.5%), and Chryseobacterium meningosepticum (13, 14.1%) were the most common pathogens causing bloodstream infections. A high concordance rate of wound cultures with blood cultures was seen in Staphylococcus aureus (3, 75%) and C. meningosepticum (8, 61.5%) infections. However, no Ralstonia isolate was found in burn wounds of patients with Ralstonia bacteremia. A high concordance rate of central venous catheter cultures with blood cultures was noted in Ralstonia mannitolilytica (5, 62.5%) and Chryseobacterium indologenes (3, 60%) infections. Approximately 21.1% of A. baumannii strains were resistant to carbapenem. All S. aureus isolates were susceptible to methicillin. Conclusions: Waterborne bacteria should be considered in patients of burns with possible water contact. Empirical broad-spectrum antibiotics should be considered for patients who were hospitalized for severe sepsis, or septic shock with a large burn. Antibiotic treatment should be administered based on the specific pathogens and their detection points. Keywords: Burn injury, Bacteremia, Resistance, Gram-negative bacteria, Formosa Fun Coast Dust Explosion |
url |
http://www.sciencedirect.com/science/article/pii/S1684118217300622 |
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doaj-be71450312794ecd818abefbd1be17a42020-11-25T01:05:30ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822018-04-01512267277The clinical and microbiological characteristics of infections in burn patients from the Formosa Fun Coast Dust ExplosionTzu-Chao Lin0Rui-Xin Wu1Chih-Chien Chiu2Ya-Sung Yang3Yi Lee4Jung-Chung Lin5Feng-Yee Chang6Department of Internal Medicine, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, TaiwanDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Corresponding author. Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan. Fax: +886 2 8792 7258.Background/Purpose: Bloodstream infection is a leading cause of mortality among burn patients. This study aimed to evaluate the risk factors, causative pathogens, and the relationship between bloodstream infections and other infections among burn patients from the Formosa Fun Coast Dust Explosion. Methods: This retrospective study evaluated the demographic and clinical characteristics, infection types, causative pathogen(s), and isolates' antibiotic susceptibilities from patients who were hospitalized between June 27 and September 31, 2015. Results: Fifty-eight patients were admitted during the study period (36 males, mean age: 22.6 years). The mean burned total body surface area (TBSA) was 40% for all patients. Eighteen (31%) patients with mean TBSA of 80% had 66 episodes of bloodstream infections caused by 92 isolates. Twelve (18.2%) episodes of bloodstream infections were polymicrobial. Acinetobacter baumannii (19, 20.7%), Ralstonia pickettii (17, 18.5%), and Chryseobacterium meningosepticum (13, 14.1%) were the most common pathogens causing bloodstream infections. A high concordance rate of wound cultures with blood cultures was seen in Staphylococcus aureus (3, 75%) and C. meningosepticum (8, 61.5%) infections. However, no Ralstonia isolate was found in burn wounds of patients with Ralstonia bacteremia. A high concordance rate of central venous catheter cultures with blood cultures was noted in Ralstonia mannitolilytica (5, 62.5%) and Chryseobacterium indologenes (3, 60%) infections. Approximately 21.1% of A. baumannii strains were resistant to carbapenem. All S. aureus isolates were susceptible to methicillin. Conclusions: Waterborne bacteria should be considered in patients of burns with possible water contact. Empirical broad-spectrum antibiotics should be considered for patients who were hospitalized for severe sepsis, or septic shock with a large burn. Antibiotic treatment should be administered based on the specific pathogens and their detection points. Keywords: Burn injury, Bacteremia, Resistance, Gram-negative bacteria, Formosa Fun Coast Dust Explosionhttp://www.sciencedirect.com/science/article/pii/S1684118217300622 |