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Infections in burned children: epidemiological analysis and risk factors
María Teresa Rosanova1, Daniel Stamboulian, Roberto Lede
1Epidemiology and Infectious Disease Control Department, Hospital Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina. margris2@yahoo.com.ar
Insights
Infection significantly increases mortality in burned children. Central venous lines, antibiotic prophylaxis, and graft requirements are key infection risk factors in pediatric burn patients.
Area of Science:
- Pediatric critical care
- Infectious disease epidemiology
- Burn management
Background:
- Burns are a leading cause of accidental death in children, with infection being a primary contributor to mortality.
- Hospital-acquired infections pose a significant threat to outcomes in pediatric burn patients.
Purpose of the Study:
- To identify independent risk factors associated with hospital-acquired infections in pediatric burn patients.
- To analyze the impact of various medical interventions and patient characteristics on infection development.
Main Methods:
- A cohort study was conducted on 110 pediatric patients admitted to a burn unit between 2007 and 2009.
- Epidemiological data on hospital-acquired infections and outcomes were collected.
- Statistical analyses, including Student's t test, Mann-Whitney Rank Sum test, X2 test, and multiple logistic regression, were employed to identify risk factors.
Main Results:
- 128 hospital-acquired infections occurred in 84 patients, with 17 deaths (15%), 14 of which were infection-related (82%).
- Infection-related factors identified included burn surface area, burn depth, antibiotic prophylaxis, central venous lines, and graft requirement.
- Multivariate analysis revealed central venous lines (RR: 5.15), antibiotic prophylaxis (RR: 5.22), and graft requirement (RR: 3.65) as independent risk factors for infection.
Conclusions:
- The presence of central venous lines, antibiotic prophylaxis, and the need for grafts are significant independent risk factors for infection in burned children.
- These findings highlight critical areas for infection control and prevention strategies in pediatric burn care.
Introduction:
Burns are the third cause of accidental deaths among children. Approximately 50-60% of these deaths are the result of an infection.
Objective:
To determine infection related risk factors in burned children.
Population And Methods:
All patients admitted to the Burn Unit of Hospital "Prof. Dr. Juan P. Garrahan" between June 2007 and December 2009 were included. The epidemiology of hospital-acquired infections and the associated outcome measures were determined. Groups of infected and non-infected children were compared using Student's t test or the Mann-Whitney Rank Sum test, as applicable. Dichotomous outcome measures were analyzed with the X2 test using Yates' correction. In order to assess the predictive value of independent outcome measures, the multiple logistic regression model was applied.
Results:
In this cohort of 110 children, 128 hospital-acquired infections were recorded in 84 patients. There were 17 deaths (15%); 14 out of these 17 (82%) were related to infection. Infection-related factors included the percentage of burned body surface area; the highest Garces' index; burn depth; antibiotic prophylaxis; the use of topical antibiotics; the presence of a central venous line, an arterial line, a urinary catheter, mechanical ventilation support, escharotomy, and the need of a graft. The multivariate analysis showed a higher risk of infection with the use of central venous lines (RR: 5.15; 95% CI: 1.44-18.46), antibiotic prophylaxis (RR: 5.22; 95% CI: 1.26-21.63), and graft requirement (RR: 3.65; 95% CI: 1.08-12.37).
Conclusions:
The presence of lines or catheters, antibiotic prophylaxis, and graft requirement were independent risk factors for infection in burned children.
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