Gram-Negative Bacilli Blood Stream Infection in Patients with Severe Burns: Microbiological and Clinical Evidence from a 9-Year Cohort
Por:
Fuentes-González, MF, Fernández-Rodríguez, D, Colín-Castro, CA, Hernández-Durán, M, López-Jácome, LE, Franco-Cendejas, R
Publicada:
1 oct 2024
Resumen:
Bloodstream infection is one of the most important and increasing complications in patients with severe burns. Most of the species affecting this population are Gram-negative bacilli that exhibit antimicrobial resistance. We conducted this study to determine the antimicrobial susceptibility profile and resistance mechanisms of these bacterial infections and their clinical associations on morbidity and mortality. We analyzed a retrospective cohort of burn patients. All patients included in this study had monobacterial blood stream infections during their hospital stay. We performed phenotypic and genotypic tests to determine the antimicrobial resistance mechanism and profile of each strain. Univariate and multivariate logistic regression analysis was performed between variables. We found 109 patients with monobacterial bacteremia. Pseudomonas spp. (50.7%), A. baumannii (46.4%), and Klebsiella spp. (13.8%) were the most common causative microorganisms. The Pseudomonas spp. isolates showed resistance to imipenem (81.5%), mainly by class A and class B carbapenemases. The A. baumannii isolates conferred resistance to imipenem (56.2%), mainly by class D carbapenemases. One quarter of Klebsiella spp. showed resistance to 3rd generation cephalosporins. We also observed that a total body surface area greater than 40% and three or more different types of invasive procedures might be related to increased mortality. Multidrug resistance is highly present. The extent of the burned area and a high number of different types of invasive procedures had an impact in decreasing survivorship in burn patients with bacteremia.
Filiaciones:
Fuentes-González, MF:
Natl Inst Resp Dis, Infect Dis & Epidemiol Dept, Mexico City 14080, Mexico
Fernández-Rodríguez, D:
Natl Inst Rehabil Luis Guillermo Ibarra Ibarra, Infect Dis Div, Clin Microbiol Lab, Mexico City 14389, Mexico
Univ Nacl Autonoma Mexico, Fac Med, Plan Estudios Combinados Med PECEM, Mexico City 04510, Mexico
Colín-Castro, CA:
Natl Inst Rehabil Luis Guillermo Ibarra Ibarra, Infect Dis Div, Clin Microbiol Lab, Mexico City 14389, Mexico
Hernández-Durán, M:
Natl Inst Rehabil Luis Guillermo Ibarra Ibarra, Infect Dis Div, Clin Microbiol Lab, Mexico City 14389, Mexico
López-Jácome, LE:
Natl Inst Rehabil Luis Guillermo Ibarra Ibarra, Infect Dis Div, Clin Microbiol Lab, Mexico City 14389, Mexico
Univ Nacl Autonoma Mexico, Chem Fac, Biol Dept, Mexico City 04510, Mexico
Franco-Cendejas, R:
Natl Inst Rehabil Luis Guillermo Ibarra Ibarra, Biomed Res Subdirect, Mexico City 14389, Mexico
gold, All Open Access; Gold Open Access
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