Document Detail


Description of Streptococcus pneumoniae infections in burn patients.
MedLine Citation:
PMID:  19765906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Longer survival in burn patients has resulted in more infectious complications, typically with Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus. Although Streptococcus pneumoniae infections are common in the community and can cause nosocomial infections, the incidence and risk factors for pneumococcal infections in burn patients is unclear.
METHODS: We performed an electronic retrospective chart review to collect rates of and risk factors for S. pneumoniae infections in patients with thermal burns from March 2003 through June 2008.
RESULTS: Of the 1838 patients admitted to the burn center, 10 were infected (0.54% incidence). Patients presented with pneumonia (seven patients, 0.38% incidence) and bacteremia (three patients, 0.16% incidence) within a week of initial burn (median 1 day, range 0-8), often in the setting of bacterial co-infection (five patients). This group was mainly young males with median 28.8% total body surface area burns; 60% had concomitant inhalational injury. Most did not have traditional risk factors for pneumococcal infection but had objective signs of infection at time of positive culture and were treated with appropriate antibiotics. Two patients in this series died, although no mortality was attributed to S. pneumoniae.
CONCLUSIONS: Pneumococcal disease is not common in burn patients and generally occurs early on in hospitalization after burn making it more likely to be a community-acquired pathogen rather than nosocomial in the burn population. It should be considered in the setting of sepsis or new pulmonary infiltrates within a week after burn, but typical empiric antibiotics against the usual burn pathogens should be adequate to also treat for pneumococcal infection.
Authors:
Jessie S Glasser; Michael L Landrum; Kevin K Chung; Duane R Hospenthal; Evan M Renz; Steven E Wolf; Clinton K Murray
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Publication Detail:
Type:  Journal Article     Date:  2009-09-18
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  36     ISSN:  1879-1409     ISO Abbreviation:  Burns     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-13     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  528-32     Citation Subset:  IM    
Copyright Information:
(c) 2009 Elsevier Ltd and ISBI. All rights reserved.
Affiliation:
Infectious Disease Service, San Antonio Military Medical Center, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Bacteremia / epidemiology*,  microbiology
Burns / microbiology*
Child
Female
Humans
Incidence
Male
Middle Aged
Pneumococcal Infections / epidemiology*,  microbiology
Pneumonia, Bacterial / epidemiology*,  microbiology
Retrospective Studies
Risk Factors
Streptococcus pneumoniae / isolation & purification
Young Adult

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