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Published on: February 9, 2011
Early burn related gram positive systemic infection in children admitted to a pediatric surgical ward
Francis Serour1, Michal Stein, Arkadi Gorenstein
1Department of Pediatric Surgery, The E. Wolfson Medical Center, P.O. Box 5, Holon, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. serour@wolfson.health.gov.il
Insights
Early burn-related gram-positive infections (EBGI) are not rare in pediatric patients, even with minor burns. Head and face burns are identified as significant risk factors for developing this serious complication.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Burn Care
Background:
- Gram-positive infections, including toxic shock syndrome (TSS), are potential early complications in pediatric burn patients.
- Early Burn-related Gram-positive Infections (EBGI) require identification of associated risk factors.
Purpose of the Study:
- To identify risk factors for early burn-related gram-positive systemic infection (EBGI) in children admitted to a Pediatric Surgical Ward.
Main Methods:
- Retrospective analysis of EBGI patients (January 1995-December 2004).
- EBGI defined by systemic infection signs within 48 hours post-burn, with toxin-mediated illness and/or positive blood cultures (Staphylococcus aureus or group A Streptococcus).
- Comparison with 150 randomly selected pediatric burn patients.
Main Results:
- 13 EBGI cases (2.5%) identified among 518 children.
- Significant risk factors included larger burned body surface area (6.9% vs 3.9%) and head/face burn localization (64% vs 31%).
- Staphylococcus aureus was cultured from burn wounds in six patients; all EBGI patients recovered with antibiotics.
Conclusions:
- Early Burn-related Gram-positive Infections (EBGI) are a notable concern in pediatric burn patients, including those with minor to moderate burns.
- Burns on the head or face are identified as potential predisposing factors for EBGI.
Background:
Gram positive infections, including toxic shock syndrome (TSS), may be an early complication following burns, especially in children.
Objective:
To identify risk factors associated with early burn related gram positive systemic infection (EBGI) in children admitted to a Pediatric Surgical Ward.
Methods:
A retrospective analysis of the records of all EBGI patients treated from January 1995 to December 2004. EBGI patients were defined as having systemic signs of infection appearing in the first 48 h following the burn and associated with: (1) clinical signs of toxin mediated illness and/or (2) positive blood culture of either Staphylococcus aureus or group A beta hemolytic Streptococcus. Demographic and clinical data were also collected from the charts of 150 randomly selected burn patients admitted during the study period.
Results:
We identified 13 cases of EBGI (2.5%) among 518 children admitted for thermal burns (mean age: 2.4 years). Three had bacteremia without rash. The 10 other patients were diagnosed as having a toxin mediated disease. S. aureus grew from the burn wound in six patients. All EBGI patients recovered following antibiotic therapy. Significant differences between the groups included: percentage of burned body surface area (6.9% versus 3.9%), and head and face localization (64% versus 31%) in the EBGI and control groups, respectively.
Conclusions:
EBGI is not rare even in pediatric patients with minor-moderate burns. Burns localized to the face or the head may be predisposing factor for such an infection.
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