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Hospital-acquired infections in pediatric burn patients
T Schlager1, J Sadler, D Weber
1Department of Pediatrics, University of Virginia, Charlottesville 22908.
Insights
Hospital-acquired infections (HAIs) in pediatric burn patients are less common than in adults. Key risk factors include large full-thickness burns and indwelling devices, with common infections being burn wound, urinary tract, and pneumonia.
Area of Science:
- Pediatric Burn Care
- Infectious Disease Epidemiology
- Hospital-Acquired Infections
Background:
- Hospital-acquired infections (HAIs) pose a significant risk to vulnerable patient populations, including pediatric burn victims.
- Understanding the specific epidemiologic characteristics of HAIs in children with burns is crucial for targeted prevention strategies.
Purpose of the Study:
- To identify the epidemiologic features of hospital-acquired infections (HAIs) in pediatric burn patients.
- To compare infection rates and characteristics between pediatric and adult burn patients.
Main Methods:
- Retrospective chart review of pediatric burn patients (<18 years) admitted between 1980 and 1988.
- Analysis of patient demographics, burn characteristics, hospital course, and infectious complications.
- Logistic regression modeling to identify risk factors for infection.
Main Results:
- 14% of 224 pediatric burn patients acquired 58 infections.
- Risk factors for infection included >20% full-thickness burns, smoke inhalation, and indwelling devices.
- Common infections were burn wound (Staphylococcus aureus, Pseudomonas aeruginosa), urinary tract (Enterobacteriaceae), pneumonia, and bacteremia.
Conclusions:
- Pediatric burn patients had a lower HAI rate than adult burn patients.
- Burn wound infections, pneumonia, and bacteremia are common in children, similar to adults.
- Urinary tract infections are more frequent in pediatric burn patients compared to adults.
Abstract:
To determine the epidemiologic characteristics of hospital-acquired infections (HAI) in pediatric burn patients, we retrospectively reviewed hospital charts of pediatric burn patients from two similar burn units. All patients less than 18 years of age admitted to the burn unit from January 1, 1980 to July 10, 1988, were enrolled. Charts were analyzed for age, sex, burn injury (type, depth, burn surface area), and hospital course (burn wound therapy, use of indwelling catheters or tubes, infectious complications, antibiotic use, cause of death if patient died). Statistical analysis was done using a logistic regression model. Of the 224 children admitted, 32 (14%) had 58 infections during their stay in the burn unit. There was no significant difference in age, sex, race, burn type or use of wound excision between patients with or without infection. Patients who acquired an infection were more likely to have sustained a > or = 20% full-thickness burn (14/32 vs 3/192 without infection), a smoke inhalation injury (10/32 vs 8/192), or have an indwelling device (29/32 vs 77/192). Thirteen (22%) of the 58 infections were burn wound infections due to Staphylococcus aureus or Pseudomonas aeruginosa, 12 (21%) were urinary tract infections due to Enterobacteriaceae, 11 (19%) were pneumonias caused by S aureus, Streptococcus pneumoniae or Pseudomonas sp, and 10 (17%) were bacteremias caused by S aureus or coagulase-negative staphylococci. The infection rate in pediatric patients hospitalized for burn injury in our study was significantly lower than the infection rate described for adult burn patients. As in adult patients, burn wound infections, pulmonary infections, and catheter-associated bacteremias are the most common infections in burned children. However, urinary tract infections are more frequent in the pediatric population. Risk factors (> or = 20% full-thickness burns, indwelling devices) and causative organisms are similar in both age groups.