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Risk factors associated with bacteremia in burn children admitted to a specialized pediatric intensive care unit: A
Hugo Basílico1, Sebastián García2, Lucas Pintos1
1Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
Insights
Central venous lines lasting over seven days significantly increase bacteremia risk in pediatric burn patients. Pseudomonas was the most common pathogen, highlighting key factors for infection control in burn care.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pediatric Burn Management
Background:
- Bacteremia in burn patients leads to severe complications, prolonged hospitalization, and increased mortality.
- Identifying causative agents and risk factors is crucial for effective infection control and reducing healthcare costs.
Purpose of the Study:
- To assess the association between various risk factors and bacteremia in pediatric burn patients.
- To identify the predominant microorganisms responsible for bacteremia in this population.
Main Methods:
- A case-control study was conducted from June 2014 to September 2019.
- Patients with positive blood cultures (cases) were compared to those with negative cultures (controls).
- Data on risk factors and microbial identification were collected from the Burn Intensive Care Unit.
Main Results:
- Twenty-nine cases of bacteremia were identified, with a median length of stay of 23 days at the time of infection.
- Central venous line use for seven days or more was a significant risk factor for bacteremia (OR: 3.18).
- Pseudomonas was the most frequent microorganism, followed by Acinetobacter and coagulase-negative Staphylococcus.
Conclusions:
- Prolonged use of central venous lines (≥7 days) is an independent risk factor for bacteremia in critically ill pediatric burn patients.
- Other investigated risk factors did not show a statistically significant association with bacteremia.
- Effective management of central venous catheters is vital for preventing bacteremia in this vulnerable patient group.
Introduction:
Infections due to bacteremia in burn patients are a common cause of complications and an extended length of stay. Knowing causative microorganisms and identifying associated risk factors allow to reduce infectious complications, morbidity, mortality, and health care expenditure. This study assesses the extent of the association between risk factors and bacteremia in burn patients and identifies the most common microorganisms found in blood cultures.
Population And Methods:
Case-control study conducted at the Burn Intensive Care Unit of Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan" between June 1st, 2014 and September 30th, 2019 in patients with bacteremia events and a positive blood culture (cases) and patients with a negative blood culture (controls).
Results:
During the study period, 29 cases of bacteremia were identified. The median length of stay at the time of bacteremia was 23 days. The most commonly identified microorganism was Pseudomonas (7 cases). The only risk factor that showed a significant association was the presence of a central venous line for 7 days or more (OR: 3.18; 95 % confidence interval: 1.20- 8.38). The overall mortality rate was 9.1%; 13.8% for cases and 3.4% for controls.
Conclusions:
Central venous lines for more than 7 days are an independent risk factor for bacteremia in critically ill burn children. No statistically significant association was established with other studied risk factors. Pseudomonas, Acinetobacter, and coagulase-negative Staphylococcus were the most common microorganisms found in bacteremia.
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