Risk factors for in-hospital acquisition of carbapenem-resistant Enterobacterales in patients with severe burns

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Burn Surgery

Background:

• Patients with severe burns are susceptible to infections by antibiotic-resistant bacteria.
• Carbapenem-resistant Enterobacterales (CRE) pose a significant threat, but specific risk factors for acquisition in burn patients remain understudied.

Purpose of the Study:

• To identify independent risk factors associated with carbapenem-resistant Enterobacterales (CRE) acquisition in patients with severe burns.

Main Methods:

• A comparative study was conducted in a burn intensive care unit (BICU).
• Patients were categorized into CRE, carbapenem-susceptible Enterobacterales (CSE), and control groups based on culture results.
• Clinical and microbiological data were analyzed to determine independent risk factors for in-hospital CRE acquisition.

Main Results:

• Among 489 patients, 20.7% acquired CRE. Independent risk factors for CRE acquisition included exposure to other CRE-acquired patients, an Abbreviated Burn Severity Index score of 9 or higher, and mechanical ventilation.
• Exposure to other CRE-acquired patients was also a significant factor when comparing CRE and CSE groups.

Conclusions:

• Enhanced infection control measures are crucial for preventing in-hospital CRE transmission in severe burn patients.
• Controlling burn severity is challenging, making robust infection control paramount.