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Infestations and chronic infections in foreign pediatric patients with burns: is there a role for specific protocols?
J P Barret1, A N Dardano, J P Heggers
1Department of Surgery, Shriners Burns Hospital-University of Texas Medical Branch, Galveston, USA.
Insights
Foreign patients in US burn centers rarely have parasitic infections, but some infestations correlate with nutritional status. Simple hand washing is crucial for preventing disease spread and protecting healthcare workers.
Area of Science:
- Infectious Diseases
- Public Health
- Tropical Medicine
Background:
- Parasitic and viral infections are common in developing countries.
- International patient admissions to US burn centers may introduce novel health challenges.
- Specific protocols are needed to manage potential infectious disease risks.
Purpose of the Study:
- To document parasitic infestations in foreign pediatric burn patients.
- To assess the need for specialized infection control protocols.
- To identify risk factors associated with parasitic infections.
Main Methods:
- Study included 62 consecutive foreign patients admitted to a pediatric burn reconstruction service.
- Evaluations included chest X-ray, hemogram, nutritional assessment, tuberculosis skin test, and stool ova and parasite analysis.
- Multiple linear regression was used to analyze correlations.
Main Results:
- No significant findings on chest radiographs or active tuberculosis.
- 16% of patients had positive stool cultures for ova and parasites, with Blastocystis hominis being most common.
- Parasite infestations correlated positively with eosinophilia, altered nutritional status, and altered mean corpuscular hemoglobin concentration.
Conclusions:
- Foreign pediatric burn patients from developing countries have a low incidence of parasitic infestations.
- Laboratory findings and nutritional status can help identify at-risk patients.
- Standard infection control measures, like hand washing, are effective in preventing disease transmission.
Abstract:
Infestations by parasites such as Mycobacterium tuberculosis and other viral infections are common in third world countries. Consequently, the admission of a significant number of foreign patients to burn centers in the United States may pose new problems, not only for inpatients but also for health care workers. To document infestations in patients from third world countries and to determine the need for specific protocols, we studied 62 consecutive foreign patients admitted to our pediatric burn reconstruction service between July 1997 and December 1998. All patients were evaluated with chest X-ray, hemogram with differential count, clinical and laboratory nutritional assessment, and skin test for tuberculosis, and stool samples were evaluated for ova and parasites. No pathologic findings were seen on chest radiographs. Only 1 patient had a positive skin test for tuberculosis, as a result of previous bacille Calmette-Guérin vaccine. Yet, 10 patients (16%) had positive stool cultures for ova and parasites that contained 29 isolates. The most frequently identified organism was Blastocystis hominis. All amoebas identified were nonpathogenic according to Centers for Disease Control criteria. Ascaris lumbricoides and 1 case of cysticercosis were found. None of the patients with parasites had clinical manifestations of parasitosis or chronic infections. However, parasite infestations had a positive correlation with eosinophilia, altered nutritional status, and altered mean corpuscular hemoglobin concentration, as defined by multiple linear regression. Although foreign patients admitted to burn centers from third world countries have a low rate of infestations, patients at risk can be identified by laboratory findings and studies of nutritional status. Simple hand washing prevents the spread of disease and protects health providers.