Risk factors of emerging multidrug resistant Acinetobacter baumannii in burn patients at burn Unit of Dr. Soetomo
M Primasari1, A S Budi2, L Hariani1
1Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Reconstructive and Aesthetic Surgery, Department of Plastic, Surabaya, Indonesia.
Introduction:
Burn injury patients are at high risk of infection as a result of the nature of the burn injury itself, including prolonged hospital stays, antibiotics use, treatment procedures, etc. In this era, nosocomial infections caused by Acinetobacter baumannii (A.ba) have increased significantly. This study was conducted to investigate the micro-organism pattern and the risk factors for burn patients with multi-drug resistant (MDR) Acinetobacter baumannii (A.ba) in the Burn Unit at Dr. Soetomo Hospital.
Materials And Methods:
We conducted a retrospective, observational study among burn patients with A.ba admitted to the Burn Unit at Dr. Soetomo Hospital from January 2020 to December 2021. Potential risk factors for MDR-A.ba were analysed by univariate and multivariate analysis. The patients diagnosed with MDR-A.ba wound infection were included in the case group. The patients diagnosed with non MDR, these are: (1) the patients isolated micro-organisms other than A.ba, (2) sterile isolates, and (3) the patients isolated as A.ba but not MDR, were included in the control group.
Results:
A total of 120 burn patients were included in this study. During this study, 24% burn patients were found to have Acinetobacter baumannii and 79% (from 24% of Acinetobacter baumannii) had MDR-A.ba. According to univariate analysis, risk factors that significant were: Abbreviated Burn Severity Index (ABSI) (p = 0,002; OR: 6.10; CI: 1,68 - 21,57); hospital Length Of Stay (LOS) (p < 0,000; OR: 6.95; CI: 2,56 - 18,91) and comorbid (p = 0,006; OR: 3,72; CI: 1,44 - 9,58). But, after analysed by multivariate analysis, only ABSI was the significant factor (p = 0,010; OR: 1,70; CI: 1,23 - 2,36).
Conclusion:
Based on univariate analysis, the significant risk factors for MDR-A.ba were: ABSI, hospital length of stay and comorbid. But after adjusted by multivariate analysis, only ABSI was the significant factor.
Insights
Burn patients face high infection risks, particularly from multi-drug resistant Acinetobacter baumannii (MDR-A.ba). The Abbreviated Burn Severity Index (ABSI) is the primary risk factor for MDR-A.ba in burn patients.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Burn Surgery
Background:
- Burn patients are susceptible to infections due to compromised skin barriers and prolonged hospital stays.
- Nosocomial infections, especially those caused by Acinetobacter baumannii (A.ba), pose a significant threat in burn units.
- Understanding the prevalence and risk factors of multi-drug resistant (MDR) A.ba is crucial for effective patient management.
Purpose of the Study:
- To investigate the microorganism patterns in burn patients.
- To identify risk factors associated with multi-drug resistant Acinetobacter baumannii (MDR-A.ba) infections in burn patients.
- To analyze the prevalence of MDR-A.ba in the Burn Unit at Dr. Soetomo Hospital.
Main Methods:
- A retrospective observational study was conducted from January 2020 to December 2021.
- Patients with MDR-A.ba wound infection were classified as the case group.
- Univariate and multivariate analyses were employed to identify risk factors for MDR-A.ba.
Main Results:
- Acinetobacter baumannii was found in 24% of 120 burn patients, with 79% of these isolates being MDR-A.ba.
- Univariate analysis identified Abbreviated Burn Severity Index (ABSI), hospital Length Of Stay (LOS), and comorbid conditions as significant risk factors.
- Multivariate analysis revealed that only ABSI remained a significant independent risk factor (p = 0.010; OR: 1.70).
Conclusions:
- ABSI, hospital LOS, and comorbid conditions were initially identified as risk factors for MDR-A.ba.
- After multivariate analysis, the Abbreviated Burn Severity Index (ABSI) was confirmed as the sole significant risk factor for MDR-A.ba in burn patients.
- These findings highlight the importance of assessing burn severity in predicting the risk of MDR-A.ba infections.
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