Cross-Border Antibiotic Resistance Patterns in Burn Patients

Area of Science:

• Infectious Diseases
• Public Health
• Burn Care

Background:

• Antimicrobial resistance (AMR) poses a global health threat, influenced by regional antibiotic stewardship variations.
• Previous studies indicate higher AMR rates in trauma patients from Mexico compared to the US.
• This suggests a potential geographic disparity in AMR patterns among burn patients.

Purpose of the Study:

• To investigate if burn patients initially injured in Mexico exhibit higher rates of AMR compared to those injured in the United States.
• To identify factors associated with AMR in burn patients, considering geographic origin.

Main Methods:

• Retrospective query of an American Burn Association (ABA)-verified burn center registry (January 2015 - December 2019).
• Inclusion criteria: burn injury admissions with hospital length-of-stay (LOS) > 7 days.
• Patients categorized by burn location (Mexico vs. USA); all bacterial infections analyzed.

Main Results:

• 73 Mexican (MEX) and 826 US (USA) patients included; similar age and gender distribution.
• MEX patients had larger median %TBSA (11.1% vs. 4.3%) and longer LOS (18.0 vs. 13.0 days).
• MEX patients showed higher rates of any resistant organism (47.2% vs. 28.1%) and respiratory infections (16.4% vs. 7.4%).
• On multivariable analysis, country of burn was not a significant predictor of AMR.

Conclusions:

• Burn patients initially injured in Mexico demonstrated higher rates of antimicrobial resistance compared to those injured in the US.
• Geographic origin of burn injury was not an independent predictor of AMR when other factors were considered.
• Continuous surveillance of AMR in burn patients, irrespective of their country of initial injury, is crucial.