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Risk Factors for Multidrug-Resistant Acinetobacter baumannii Infections in a Mass Burn Casualty Incident

Eng-Kean Yeong1,2, Wei-Lieh Huang3,4

  • 1Department of Surgery, National Taiwan University Hospital, National Taiwan.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|June 15, 2019
PubMed

Insights

Large burn size and extensive antibiotic use increase the risk of multidrug-resistant Acinetobacter baumannii infections in burn patients. Prior vancomycin treatment also elevates infection risk.

Area of Science:

  • Infectious Diseases
  • Burn Care
  • Microbiology

Background:

  • Multidrug-resistant Acinetobacter baumannii (MDRAB) poses a significant threat in healthcare settings, particularly in burn patients.
  • Identifying risk factors for MDRAB infections is crucial for developing effective prevention and treatment strategies in mass casualty burn incidents.

Purpose of the Study:

  • To investigate the risk factors associated with multidrug-resistant Acinetobacter baumannii infections in burn patients following a mass casualty event.
  • To analyze the correlation between various clinical variables and the incidence of MDRAB infections.

Main Methods:

  • A retrospective study involving 33 burn patients admitted during a mass burn casualty event.
  • Independent variables included patient demographics, burn size, and antibiotic exposure (specific drugs, classes, and duration).
  • Logistic regression and structural equation modeling were employed to analyze risk factors and their interrelationships.

Main Results:

  • The incidence of MDRAB infection was 39% (13/33 patients).
  • Increased burn size (per 1% increase), greater number of antibiotic classes used, longer duration of antibiotic use, and prior vancomycin treatment were significant risk factors for MDRAB infection.
  • Burn size was identified as the fundamental risk factor in a structural equation model.

Conclusions:

  • Burn size, extensive antibiotic exposure (both breadth and duration), and prior vancomycin use are significantly correlated with the risk of developing MDRAB infections in burn patients.
  • These findings highlight the importance of judicious antibiotic stewardship and comprehensive burn management to mitigate MDRAB infection risks.

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