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Epidemiological and bacteriological profiles in children with burns
Amjed Fekih Hassen1, Sonia Ben Khalifa1, Mayssa Daiki1
1Department of Anaesthesia and Intensive Care, Children's Hospital, Tunis El Manar University, Bab Saadoun 1007, Tunis, Tunisia.
Insights
Methicillin-susceptible Staphylococcus aureus (MSSA) and wild-type Pseudomonas aeruginosa were the most common causes of nosocomial infections (NI) in burned children. Early empiric antibiotic treatment is recommended.
Area of Science:
- Infectious Diseases
- Pediatric Burn Care
- Microbiology
Background:
- Nosocomial infections (NI) pose a significant threat to hospitalized burned children.
- Identifying prevalent pathogens is crucial for effective treatment strategies.
Purpose of the Study:
- To determine the most prevalent bacteria responsible for nosocomial infections in burned children.
- To guide empiric antibiotic therapy in this vulnerable population.
Main Methods:
- A prospective analytic study was conducted over 30 months at the Children's Hospital of Tunisia.
- Burned children admitted to the hospital were enrolled in the study.
Main Results:
- The incidence rate of NI was 39.1 per 1000 patient-days, with two-thirds of infections being polymicrobial.
- The most common isolated microorganisms were methicillin-susceptible Staphylococcus aureus (MSSA, 57.7%), wild-type Pseudomonas aeruginosa (35.9%), and wild-type Enterobacter cloacae (26.9%).
- The case fatality rate was 5.9%, with septic shock and multiple organ failure being the leading causes of death.
Conclusions:
- Wild-type strains of MSSA and Pseudomonas aeruginosa were the predominant pathogens causing NI in burned children.
- Empiric antibiotic treatment combining piperacillin, oxacillin, and gentamicin is suggested for suspected sepsis until causative agents are identified.
Objectives:
The aim of our study is to determine the most prevalent bacteria responsible for nosocomial infection (NI) in burned children.
Materials And Methods:
A prospective analytic study was conducted over a period of 30 months at the Children's Hospital of Tunisia. All burned children were enrolled.
Results:
A total of 185 children were hospitalised during the study period. The mean age was 30 months (interquartile range, IR:18; 48). The gender ratio of the study population was 1.3 (104 males and 81 females). The mean total body surface area burned (TBSA) was 10% (IR:6; 16). The incidence rate of NI was 39.1 NIs per 1000 patient-days and two-thirds of the infections were polymicrobial. The most common isolated micro-organisms were methicillin-susceptible Staphylococcus aureus (MSSA, 57.7%), wild-type Pseudomonas aeruginosa (35.9%) and wild-type Enterobacter cloacae (26.9%). The case fatality rate was 5.9% corresponding to a crude death rate of 1.32 deaths per year. Septic shock with multiple organ failure was the leading cause of death.
Conclusion:
The most common micro-organisms responsible for NI in our series were of the wild-type phenotype. Thus, on suspicion of sepsis, empiric antibiotic treatment combining piperacillin, oxacillin and gentamicin can be proposed until identification of the causative microorganism is available.
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