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. 2023 Sep 11;12(9):1432.
doi: 10.3390/antibiotics12091432.

Risk Factors and Pathogens of Wound Infection in Burn Inpatients from East China

Siqi Zhou  1 , Shuzhen Xiao  1   2 , Xuedong Wang  1   2 , Xuefeng Wang  1 , Lizhong Han  1   2
Affiliations

Risk Factors and Pathogens of Wound Infection in Burn Inpatients from East China

Siqi Zhou et al. Antibiotics (Basel). .

Abstract

Background: Infection is the predominant contributor to morbidity and mortality in burn patients, and burn wound infection (BWI) is the most common reason. The objective of this research was to analyze the incidence, factors and progression of BWI, in terms of events and bacteria.

Methods: Clinical variables of all qualified patients admitted to burn wards were analyzed retrospectively in 2021 at a tertiary hospital in eastern China through univariate analysis and multivariate logistic regression. The Kaplan-Meier method was also used for plotting survival curves. Isolates and resistance data were evaluated to demonstrate the evolution of targeted antibiotics of strains from BWI.

Results: A total of 580 (median age, 39.5 years (23-56 years); 372/580 (64.14%) male) patients were evaluated, 348 (60.0%) of whom experienced BWI. A variety of factors are associated with BWI. Multivariate logistic regression analysis showed that depth and area of burn and duration from burn to first hospitalization are independent risk factors for BWI. For BWI onset in these patients, 47.24% (274/580) occurred in the first week. The most frequently isolated causative organism was Staphylococcus aureus (15.7%) in patients with BWI. The duration of transition from Gram-positive strains (median 3 days, (2-7 days)) to Gram-negative (median 10 days, (4-17 days)) ones isolated from burn wound shrunk. Hospital length of stay was considered as a protective factor for BWI.

Conclusion: The precise assessment of factors affecting BWI in burn patients enhances prompt and suitable management. Swab cultures for surveillance could be utilized to monitor the microbiological status of burn patients.

Keywords: burn wound; burn wound infection; epidemiology; pathogenesis; resistance; risk factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The association among etiology, depth, segments and % TBSA (the percentage of total body surface area) of burn. The X-axis of the bubble plot refers to the different etiologies of burn injuries, while the Y-axis refers to the TBSA of burns for each individual. The size of the bubbles indicates the number of affected anatomical segments for each patient, and the color represents the depth of the burn injuries. Depth II—burns extend into the underlying skin layer (dermis). Depth III—burns extend into full thickness. Depth II/III—Both of Depth II and III.
Figure 2
Figure 2
The cumulative incidence of infection from hospital admission to day 28.
Figure 3
Figure 3
Kaplan–Meier curves of 30-days infection-free survival function by different factors. The dotted lines in the first subfigure mean 95% confidence interval of the global infection free survival function.
Figure 4
Figure 4
Boxplot representation of the time from injury to positive cultures by classes of microorganisms. Different strains are represented by different colors. ‘+’ —the mean. The vertical line—the median.
See this image and copyright information in PMC

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