Healthcare-associated infections in burn patients: Timeline and risk factors

Background: Healthcare-associated infections (HAIs) remain a major challenge in burn research and care. We aimed to describe the epidemiology and timeline of HAIs and to estimate the association of demographics and clinical characteristics with time to HAI among burn patients. Methods: A prospective cohort study was conducted in a referral burn unit in southwestern Colombia. Incidence rates were calculated for HAI types and microorganisms, using a Poisson regression model. Univariable and multivariable Cox proportional hazards regression was used to estimate the effect of risk factors on time to first HAI. Results: Of 165 burn patients, 46 (27.9%) developed at least one HAI (incidence rate of 21.8 per 1000 patient-days). The most frequent HAIs were burn wound infections, followed by bloodstream infections. The most common microorganisms were Staphylococcus aureus, Pseudomonas spp., and Acinetobacter baumannii. Whereas gram-negative bacteria were the most common microorganisms causing HAIs, gram-positive bacteria were the first microorganisms isolated after hospital admission. The independent risk factors associated with time to first HAI were burn size (TBSA > 20%), burn mechanism (flames and scalds), central venous catheter use, and mestizo race. Conclusion: These data have implications toward generating empirical antibiotic guidelines and preventive strategies targeting the patients at highest risk for HAI. (C) 2020 Elsevier Ltd and ISBI. All rights reserved.