Document Detail


The impact of nosocomially-acquired resistant Pseudomonas aeruginosa infection in a burn unit.
MedLine Citation:
PMID:  17622885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nosocomially-acquired Pseudomonas aeruginosa remains a serious cause of infection and septic mortality in burn patients. This study was conducted to quantify the impact of nosocomially-transmitted resistant P. aeruginosa in a burn population. METHODS: Using a TRACS burn database, 48 patients with P. aeruginosa resistant to gentamicin were identified (Pseudomonas group). Thirty-nine were case-matched to controls without resistant P. aeruginosa cultures (control group) for age, total body surface area, admission year, and presence of inhalation injury. Mortality and various morbidity endpoints were examined, as well as antibiotic costs. RESULTS: There was a significantly higher mortality rate in the Pseudomonas group (33% vs. 8%, p < 0.001) compared with in the control group. Length of stay was increased in the Pseudomonas group (73.4 +/- 11.6 vs. 58.3 +/- 8.3 days). Ventilatory days (23.9 +/- 5.4 vs. 10.8 +/- 2.4, p < 0.05), number of surgical procedures (5.2 +/- 0.6 vs. 3.4 +/- 0.4, p < 0.05), and amount of blood products used (packed cells 51.1 +/- 8.0 vs. 21.1 +/- 3.4, p < 0.01; platelets 11.9 +/- 3.0 vs. 1.4 +/- 0.7, p < 0.01) were all significantly higher in the Pseudomonas group. Cost of antibiotics was also significantly higher ($2,658.52 +/- $647.93 vs. $829.22 +/- $152.82, p < 0.01). CONCLUSIONS: Nosocomial colonization or infection, or both, of burn patients with aminoglycoside-resistant P. aeruginosa is associated with significantly higher morbidity, mortality, and cost of care. Increased resource consumption did not prevent significantly higher mortality rates when compared with that of control patients. Thus, prevention, identification, and eradication of nosocomial Pseudomonas contamination are critical for cost-effective, successful burn care.
Authors:
Alexis D Armour; Heather A Shankowsky; Todd Swanson; Jonathan Lee; Edward E Tredget
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  63     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-11     Completed Date:  2007-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-71     Citation Subset:  AIM; IM    
Affiliation:
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Alberta Hospital, Edmonton, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Alberta
Anti-Bacterial Agents / economics,  pharmacology
Burns / economics,  microbiology*,  mortality
Case-Control Studies
Cross Infection
Crown-Rump Length
Female
Gentamicins / pharmacology
Humans
Male
Pseudomonas Infections* / economics,  mortality
Pseudomonas aeruginosa / drug effects
Respiration, Artificial
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gentamicins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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