Hospital-onset bacteremia and fungemia in a regional burn intensive care unit

Bacteremia is a common complication in burn patients. Hospital-onset bacteremia and fungemia (HOB) has been proposed as a quality measure for value-based purchasing programs. We sought to describe the characteristics of HOB in a regional burn center.

Patients admitted to the burn intensive care unit from September 2018 through December 2024 were identified through the burn registry. Microbiologic and patient data were extracted from the electronic medical record and Vizient database.

One hundred seventy-nine (88.6%) of 202 bacteremia episodes were categorized as HOB in 1,612 patients. The most common organisms isolated were Pseudomonas aeruginosa (18.2%), methicillin-resistant (15%) and methicillin sensitive (8%) Staphylococcus aureus and Klebsiella pneumoniae complex (6.6%). Seventy-two (35.6%) of the 202 bacteremia episodes, 66 (36.8%) of the 179 HOB episodes occurred within 2 days after a soft tissue surgical procedure.

HOB is common in burn patients and varies with total body surface area burned. In 36.8% of cases, HOB was associated with soft tissue with surgical procedures 2 days before the onset of bacteremia. HOB may not be an indicator of quality for burn patients. Further studies are needed to understand modifiable risk factors for bacteremia in this patient population.