Risk factors for multidrug‐resistant Gram‐negative infection in burn patients

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Critically ill burn patients are at a high risk of bacterial infection during their stay in the intensive care unit (ICU). The reasons for this include loss of a protective skin barrier, depressed immune function, presence of compromised avascular tissue, extended periods of hospitalization and the requirement for invasive diagnostic and therapeutic interventions.1
More than 75% of deaths following a burn injury are directly attributable to infection3 and multidrug‐resistant (MDR) organisms increase mortality from 42% to 86% in patients with burn‐related sepsis.5 Gram‐negative bacteria constitute approximately 70% of identified pathogens isolated from ICU burn patients and commonly include Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Enterobacter species.8 These organisms may often be MDR, thus reducing therapeutic options and potentially delaying time to appropriate antibiotic therapy.8 In turn, this may lead to prolonged ICU stay and increased hospital costs or even death.2 Given this, it is important to identify the risk factors for MDR Gram‐negative organism infection so that, if possible, they can be minimized to try and improve outcomes in this high‐risk group of patients.
The aim of this study was to identify the risk factors for infection by MDR Gram‐negative pathogens in critically ill burn patients admitted to a major tertiary referral ICU in Australia.

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