The impact of nosocomially-acquired resistant Pseudomonas aeruginosa infection in a burn unit
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Updated: Jul 13, 2026
Replication of the Ordered, Nonredundant Library of Pseudomonas aeruginosa strain PA14 Transposon Insertion Mutants
Published on: May 4, 2018
Alexis D Armour1, Heather A Shankowsky, Todd Swanson
1Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Alberta Hospital, Edmonton, Alberta, Canada.
Background:
Nosocomially-acquired Pseudomonas aeruginosa remains a serious cause of infection and septic mortality in burn patients. This study was conducted to quantify the impact of nosocomially-transmitted resistant P. aeruginosa in a burn population.
Methods:
Using a TRACS burn database, 48 patients with P. aeruginosa resistant to gentamicin were identified (Pseudomonas group). Thirty-nine were case-matched to controls without resistant P. aeruginosa cultures (control group) for age, total body surface area, admission year, and presence of inhalation injury. Mortality and various morbidity endpoints were examined, as well as antibiotic costs.
Results:
There was a significantly higher mortality rate in the Pseudomonas group (33% vs. 8%, p < 0.001) compared with in the control group. Length of stay was increased in the Pseudomonas group (73.4 +/- 11.6 vs. 58.3 +/- 8.3 days). Ventilatory days (23.9 +/- 5.4 vs. 10.8 +/- 2.4, p < 0.05), number of surgical procedures (5.2 +/- 0.6 vs. 3.4 +/- 0.4, p < 0.05), and amount of blood products used (packed cells 51.1 +/- 8.0 vs. 21.1 +/- 3.4, p < 0.01; platelets 11.9 +/- 3.0 vs. 1.4 +/- 0.7, p < 0.01) were all significantly higher in the Pseudomonas group. Cost of antibiotics was also significantly higher ($2,658.52 +/- $647.93 vs. $829.22 +/- $152.82, p < 0.01).
Conclusions:
Nosocomial colonization or infection, or both, of burn patients with aminoglycoside-resistant P. aeruginosa is associated with significantly higher morbidity, mortality, and cost of care. Increased resource consumption did not prevent significantly higher mortality rates when compared with that of control patients. Thus, prevention, identification, and eradication of nosocomial Pseudomonas contamination are critical for cost-effective, successful burn care.
Insights
Nosocomial Pseudomonas aeruginosa infections significantly increase mortality and morbidity in burn patients. Effective prevention and eradication strategies are crucial for better patient outcomes and cost-effective care.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Burn Surgery
Background:
- Nosocomial Pseudomonas aeruginosa infections pose a significant threat to burn patients, leading to increased mortality.
- This study quantifies the impact of nosocomially transmitted, resistant P. aeruginosa within a burn patient population.
Purpose of the Study:
- To assess the impact of nosocomial Pseudomonas aeruginosa infections on mortality, morbidity, and healthcare costs in burn patients.
- To compare outcomes between burn patients with resistant P. aeruginosa and a matched control group.
Main Methods:
- A retrospective analysis of a burn database (TRACS) was performed.
- 48 patients with gentamicin-resistant P. aeruginosa (Pseudomonas group) were case-matched with 39 controls.
- Mortality, morbidity endpoints (length of stay, ventilatory days, surgical procedures, blood product usage), and antibiotic costs were examined.
Main Results:
- The Pseudomonas group exhibited a significantly higher mortality rate (33% vs. 8%, p < 0.001).
- Increased length of stay, ventilatory days, surgical procedures, and blood product usage were observed in the Pseudomonas group.
- Antibiotic costs were substantially higher in the Pseudomonas group ($2,658.52 vs. $829.22, p < 0.01).
Conclusions:
- Aminoglycoside-resistant P. aeruginosa in burn patients is linked to significantly higher morbidity, mortality, and healthcare costs.
- Despite increased resource utilization, mortality rates remained higher in the Pseudomonas group.
- Prevention, identification, and eradication of nosocomial Pseudomonas contamination are essential for cost-effective burn care.
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