Analysis of Potential Risk Factors for Multidrug-Resistance at a Burn Unit

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Burn Care

Background:

• Multidrug-resistant (MDR) microorganisms pose significant threats, increasing morbidity and mortality in burn patients.
• A five-year analysis was conducted at Coimbra Burns Unit (CBU) in Portugal to track MDR bacteria evolution.
• The study sought to identify potential associations between specific MDR bacteria and risk factors in burn patients.

Purpose of the Study:

• To analyze the temporal trends of multidrug-resistant (MDR) bacteria in burn patients over a five-year period.
• To investigate potential risk factors associated with the development of MDR bacterial infections in this vulnerable population.
• To understand the evolution and prevalence of specific MDR bacterial species within a specialized burn unit.

Main Methods:

• Microbiological samples (blood, catheter, urine, aspirate, wound) from burn patients were analyzed for bacterial identification.
• Univariate and multivariate models were employed to assess risk factors for MDR bacterial species infecting at least 50 patients or having five or more MDR strains.
• Statistical significance was determined using hypothesis tests with a p-value threshold of less than 0.05.

Main Results:

• A total of 341 samples yielded 107 multidrug-resistant (MDR) isolates across 10 bacterial species.
• No significant overall variation in MDR bacteria frequency was observed during the five-year study period.
• While some species showed trends with specific risk factors, no single factor was linked to all MDR bacteria.

Conclusions:

• The development of multidrug-resistant (MDR) infections in burn patients is multifactorial, influenced by prolonged hospitalization, invasive devices, and suboptimal antimicrobial therapy.
• The impact of these risk factors varies among specific bacterial species and may depend on individual patient factors, treatment, and local microbial flora.
• Continuous microbiological surveillance, rapid diagnostics, and timely, appropriate antimicrobial treatment are essential for improving outcomes in multidrug-resistant infections among burn patients.