A 16-Year-Old Male Patient With Severe Electrical Burns With Chronic and Recurrent Hospital-Acquired Opportunistic...

BACKGROUND Acinetobacter baumannii is an opportunistic gram-negative bacterium found in health facilities, including intensive care units (ICUs), and for patients with burn injuries, it can cause severe wound infections and systemic infection. Electrical burn is a unique type of trauma. Burns and electrical injuries disrupt the integrity of skin and mucous membrane barriers, which results in impairment of the body's defense mechanisms, thus significantly increasing the possibility of infection. This report describes the case of a 16-year-old male patient with severe electrical burns and chronic and recurrent ICU-acquired opportunistic infection with carbapenem-resistant A. baumannii (CRAB). CASE REPORT A 16-year-old male patient was admitted with 220-V electrical burns and was subsequently transferred to the ICU. On admission, he had impaired consciousness and recurrent fever, complicated by respiratory failure, gastrointestinal bleeding, nasal hemorrhage, hypoxic brain injury, and pulmonary infection. During hospitalization, cutaneous ulceration of the left lower limb, necrosis of the third to fifth toes of the left foot, and skin lesions involving the buttocks, sacrococcygeal region, and occiput developed sequentially. CRAB was successively isolated from sputum, blood, and multiple skin wound specimens. The patient underwent repeated debridement, wound expansion, and limb reconstructive surgery. He was discharged in stable condition after 156 days of hospitalization. CONCLUSIONS Early identification of CRAB colonization and invasive infection is essential. Strict infection control measures should be implemented in ICUs and burn wards. This case provides clinical reference for the management of recurrent CRAB infection in patients with severe electrical burns and for the prevention and control of nosocomial infection.