The Profile of Bacterial Infections in a Burn Unit during and after the COVID-19 Pandemic Period
Abstract
:1. Introduction
2. Results
2.1. Clinical Samples
2.2. Clinical Isolates
3. Discussion
4. Materials and Methods
4.1. Microbiology Procedures
4.2. Statistical Method
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | 2020 | 2023 | |||
---|---|---|---|---|---|
Nr. (%) | 95%CI * | Nr. (%) | 95%CI | p | |
Patients | N1 = 48 | N2 = 69 | |||
Women patients, F (%) | 16 (33.33) | [20.40–48.41%] | 20 (28.99) | [18.69–41.16%] | 0.685 |
Male patients, M (%) | 32 (66.67) | [51.59–79.60%] | 49 (71.01) | [58.84–81.31%] | |
Median Age [IQR] | 59.00 [47.50–70.50] | / | 49.00 [35.00–61.00] | / | 0.005 |
Patients aged 18–19 (%) | 1 (2.08) | [0.05–11.07%] | 1 (1.45) | [0.04–7.81%] | 1.00 |
Patients aged 20–29 (%) | 0 (0) | / | 10 (14.49) | [7.17–25.04%] | 0.005 |
Patients aged 30–39 (%) | 5 (10.42) | [3.47–22.66%] | 12 (17.39) | [9.32–28.41%] | 0.424 |
Patients aged 40–49 (%) | 8 (16.67) | [7.48–30.22%] | 12 (17.39) | [9.32–28.41%] | 1.00 |
Patients aged 50–59 (%) | 10 (20.83) | [10.47–34.99%] | 15 (21.74) | [12.71–33.31%] | 1.00 |
Patients aged 60–69 (%) | 11 (22.92) | [12.03–37.31%] | 9 (13.04) | [6.14–23.32%] | 0.212 |
Patients aged 70–79 (%) | 5 (10.42) | [3.47–22.66%] | 7 (10.14) | [4.18–19.79%] | 1.00 |
Patients aged 80–89 (%) | 7 (14.58) | [6.07–27.76%] | 2 (2.90) | [0.35–10.08%] | 0.031 |
Patients aged 90–99 (%) | 1 (2.08) | [0.05–11.07%] | 1 (1.45) | [0.04–7.81%] | 1.00 |
Median length of stay [IQR] | 20.00 [12.00–52.00] | / | 19 [8.00–41.00] | / | 0.745 |
Median fatality [IQR] | 3.00 [2.00–4.00] | / | 2.00 [1.00–3.00] | / | 0.023 |
Fatality Rate | 0–1% | 2% | 10–20% | 30–50% | 60–80% | >80% |
---|---|---|---|---|---|---|
G23 nr. (%) | 5 (7.25) | 17 (24.64) | 16 (23.19) | 16 (23.19) | 6 (8.69) | 9 (13.04) |
G20 nr. (%) | 0 | 7 (14.58) | 8 (16.67) | 15 (31.25) | 11 (22.92) | 7 (14.58) |
Variable | Fatal Outcome | Positive Evolution | ||||||
---|---|---|---|---|---|---|---|---|
N1 = 33 | 95%CI * | N2 = 80 | 95%CI | p | OR | p | HR | |
Median age [IQR] | 64.00 [49.00–71.00] | / | 50.00 [35.00–62.00] | / | 0.005 | 1.04 [1.01–1.06] | 0.002 | 1.12 [1.04–1.21] |
Body surface [IQR] | 40.00 [16.00–65.00] | / | 14.50 [5.50–24.50] | / | <0.001 | 1.06 [1.03–1.08] | 0.001 | 1.12 [1.05–1.21] |
Burn dressing ≥10% of BS (%) | 23 (69.70) | [51.29–84.41%] | 38 (47.50) | [36.21–58.98%] | 0.039 | 2.54 [1.07–6.02] | 0.008 | 0.02 [0.00–0.37] |
Ventilatory support (%) | 27 (81.82) | [64.54–93.02%] | 13 (16.25) | [8.95–26.18%] | <0.001 | 23.19 [7.99–67.31] | 0.002 | 37.32 [3.65–381.05] |
Haemo-dialysis (%) | 13 (39.39) | [22.91–57.86%] | 2 (2.50) | [0.30–8.74%] | <0.001 | 25.35 [5.29–121.57] | 0.006 | 47.11 [2.99–740.36] |
Patients infected with | ||||||||
Acinetobacter spp. (%) | 21 (63.64) | 19 (23.75) | <0.001 | 5.61 [2.34–13.49] | 0.019 | 9.02 [1.44–56.62] |
Species | 2020 | 2023 | |||
---|---|---|---|---|---|
Nr. (%) | 95%CI * | Nr. (%) | 95%CI | p | |
Wound secretions | |||||
S. aureus | 23 (16.31) | [10.63–23.46%] | 31 (18.45) | [12.90–25.16%] | 0.654 |
Enterococcus spp. | 21 (14.89) | [9.46–21.86%] | 22 (13.10) | [8.39–19.15] | 0.366 |
Pseudomonas spp. | 19 (13.48) | [8.31–20.24%] | 21 (12.50) | [7.91–18.47%] | 0.865 |
Bacillus cereus | 5 (3.55) | [1.16–8.08%] | 20 (11.90) | [7.43–17.79%] | 0.010 |
Acinetobacter spp. | 19 (13.48) | [8.31–20.24%] | 19 (11.31) | [6.95–17.10%] | 0.604 |
Klebsiella spp. | 13 (9.22%) | [5.00–15.25%] | 16 (9.52) | [5.54–15.01%] | 1.00 |
CNS | 10 (7.09) | [3.45–12.66%] | 1 (0.60) | [0.02–3.27%] | 0.032 |
Blood cultures | |||||
CNS | 21 (36.21) | [23.99–49.88%] | 15 (28.85) | [17.13–43.08%] | 0.424 |
S. aureus | 7 (12.07) | [4.99–23.30%] | 12 (23.08) | [12.53–36.84%] | 0.139 |
A. baumannii | 12 (20.69) | [11.17–33.35%] | 8 (15.38) | [6.88–28.08%] | 0.621 |
Klebsiella spp. | 2 (3.45) | [0.42–11.91%] | 3 (5.77) | [1.21–15.95%] | 0.665 |
Enterococcus spp. | 2 (3.45) | [0.42–11.91%] | 3 (5.77) | [1.21–15.95%] | 0.665 |
Bronchial aspirates | |||||
A. baumannii | 12 (35.29) | [19.75–53.51%] | 7 (23.33) | [9.93–42.28%] | 0.412 |
S. maltophilia 1 | 0 (0) | / | 4 (13.33) | [3.76–30.72%] | 0.043 |
Pseudomonas spp. | 4 (11.76) | [3.30–27.45%] | 3 (10.00) | [2.11–26.53%] | 1.00 |
S. Paucimobilis 2 | 0 (0) | / | 2 (6.67) | [0.82–22.07%] | 0.216 |
Klebsiella spp. | 2 (5.88) | [0.72–19.68%] | 2 (6.67) | [0.82–22.07%] | 1.00 |
Strains | 2020 | 2023 | |||
---|---|---|---|---|---|
N = 245 (%) | 95%CI * | N = 245 (%) | 95%CI | p | |
GNB of which: | 134 (54.69) | [48.23–61.04%] | 140 (51.28) | [45.18–57.35%] | 0.480 |
Non-fermenting | 74 (30.20) | [24.52–36.37%] | 76 (27.84) | [22.61–33.56%] | 0.562 |
GPC | 101 (41.22) | [35.00–47.67%] | 123 (45.05) | [39.05–51.17%] | 0.424 |
Fungi | 10 (4.08) | [1.97–7.38%] | 10 (3.66) | [1.77–6.63%] | 0.823 |
2020 | 2023 | ||||
---|---|---|---|---|---|
PHENOTYPE | Nr. (%) | 95%CI * | Nr. (%) | 95%CI | p |
Species: Acinetobacter baumannii TOTAL = 46/34 | |||||
MDR | 45 (97.83) | [88.47–99.94%] | 34 (100) | [89.72–100.00%] | 1.00 |
XDR | 28 (60.87) | [45.37–74.91%] | 26 (76.47) | [58.83–89.25%] | 0.156 |
PDR | 0 (0) | / | 0 (0) | / | / |
CR-GNB | 42 (91.30) | [79.21–97.58%] | 30 (88.24) | [72.55–96.70%] | 0.717 |
R-SXT | 40 (86.96) | [73.74–95.06%] | 30 (88.24) | [72.55–96.70%] | 1.00 |
Species: Staphylococcus aureus TOTAL = 34/49 | |||||
MRSA | 14 (41.18) | [24.65–59.30%] | 22 (44.90) | [30.67–59.77%] | 0.823 |
MDR | 20 (58.82) | [40.70–75.35%] | 19 (38.77) | 25 (51.02) | 0.079 |
MLSB | 10 (29.41) | [15.10–47.48%] | 22 (44.90) | [30.67–59.77%] | 0.176 |
R-FQ | 7 (20.59) | [8.70–37.90%] | 16 (32.65) | [19.95–47.54%] | 0.319 |
R-SXT | 8 (23.53) | [10.75–41.17%] | 4 (8.16) | [2.27–19.60%] | 0.062 |
Species: Coagulase-negative staphylococci TOTAL = 33/16 | |||||
MRCNS | 11 (33.33) | [17.96–51.83%] | 10 (62.50) | [35.43–84.80%] | 0.069 |
MLSB | 0 (0) | / | 2 (12.50) | [1.55–38.35%] | 0.102 |
Species: Pseudomonas spp. TOTAL = 27/29 | |||||
MDR | 5 (18.52) | [6.30–38.08%] | 13 (44.83) | [26.45–64.31%] | 0.047 |
CR-GNB | 7 (25.93) | [11.11–46.28%] | 11 (37.93) | [20.69–57.74%] | 0.399 |
XDR | 4 (14.81) | [4.19–33.73%] | 8 (27.59) | [12.73–47.24%] | 0.334 |
PDR | 0 (0) | / | 0 (0) | / | / |
Species: Enterococcus spp. TOTAL = 23/25 | |||||
VRE | 1 (4.35) | [0.11–21.95%] | 1 (4.00) | [0.10–20.35%] | 1.00 |
Species: Klebsiella spp. TOTAL = 18/22 | |||||
MDR | 2 (11.11) | [1.38–34.71%] | 5 (22.73) | [7.82–45.37%] | 0.427 |
XDR | 3 (16.67) | [3.58–41.42%] | 1 (4.55) | [0.12–22.84%] | 0.333 |
PDR | 1 (5.55) | [0.14–27.29%] | 9 (40.91) | [20.71–63.65%] | 0.013 |
ESBL | 8 (44.44) | [21.53–69.24%] | 11 (50) | [28.22–71.78%] | 0.761 |
CR-GNB | 6 (33.33) | [13.34–59.01%] | 12 (54.55) | [32.21–75.61%] | 0.216 |
R-AG | 4 (22.22) | [6.41–47.64%] | 11 (50) | [28.22–71.78%] | 0.104 |
R-FQ | 5 (27.78) | [9.69–53.48%] | 13 (59.09) | [36.35–79.29%] | 0.062 |
R-SXT | 3 (16.67) | [3.58–41.42%] | 11 (50) | [28.22–71.78%] | 0.045 |
ABSI | Life Threat | Survival Probability (%) | Fatality Rate (%) |
---|---|---|---|
2–3 | Very low | ≥99% | ≤1% |
4–5 | Moderate | 98% | 2% |
6–7 | Moderately severe | 80–90% | 10–20% |
8–9 | Serious | 50–70% | 30–50% |
10–11 | Severe | 20–40% | 60–80% |
≥12 | Maximal | ≤10% | ≥90% |
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Musuroi, C.; Musuroi, S.-I.; Baditoiu, L.; Crainiceanu, Z.; Muntean, D.; Voinescu, A.; Izmendi, O.; Sirmon, A.; Licker, M. The Profile of Bacterial Infections in a Burn Unit during and after the COVID-19 Pandemic Period. Antibiotics 2024, 13, 823. https://doi.org/10.3390/antibiotics13090823
Musuroi C, Musuroi S-I, Baditoiu L, Crainiceanu Z, Muntean D, Voinescu A, Izmendi O, Sirmon A, Licker M. The Profile of Bacterial Infections in a Burn Unit during and after the COVID-19 Pandemic Period. Antibiotics. 2024; 13(9):823. https://doi.org/10.3390/antibiotics13090823
Chicago/Turabian StyleMusuroi, Corina, Silvia-Ioana Musuroi, Luminita Baditoiu, Zorin Crainiceanu, Delia Muntean, Adela Voinescu, Oana Izmendi, Alexandra Sirmon, and Monica Licker. 2024. "The Profile of Bacterial Infections in a Burn Unit during and after the COVID-19 Pandemic Period" Antibiotics 13, no. 9: 823. https://doi.org/10.3390/antibiotics13090823