Burn Septicaemia in Kuwait: Associated Demographic and Clinical Factors

Abstract

Objective: To study the demographic and clinical factors associated with burn septicaemia patients in Kuwait. Materials and Methods: All burn in-patients, who developed septicaemia at the Burns Unit, Al-Babtain Centre for Burns and Plastic Surgery, Kuwait, during a 9-year period (June 1992 to May 2001) were included in the study. The data were recorded for age, sex, nationality, cause and percentage of burns, inhalation injury, resuscitation, number of episodes, septicaemia on post-burn day, the microorganisms responsible in each episode, treatment and outcome for statistical analysis. Using SPSS (PC version 11.0) software, a probability level of p < 0.05 was considered significant. Results: Of the 2,082 patients treated in the Burns Unit, 166 [8%; 99 (60%) males and 67 (40%) females] with a mean age of 26 years (range 1–70) had septicaemia. Significantly higher (p < 0.001) cases were recorded among Kuwaiti children (≤14 years) and non-Kuwaitis (25–59 years) than other corresponding age groups. The total body surface area burned ranged from 2 to 95% (mean 42%) and the main cause of burn was flame (77.1%). Inhalation injury was diagnosed in 39 (23.5%) patients. A total of 253 septicaemic episodes occurred in all patients. The majority, 123 (74.1%), had a single episode and the remaining 43 (25.6%) had multiple (2–10) episodes. One hundred and fifty-five (61.3%) episodes were due to gram-positive organisms, mainly methicillin-resistant Staphylococcus aureus, and 32 (12.7%) were polymicrobial. One hundred and twenty-four (74.7%) patients had wound excision and skin grafting procedures and their survival was significantly higher (OR = 4.3; 95% CI: 1.98–9.31) than non-surgically treated patients. Thirty-nine (23.5%) patients died mainly due to multi-organ failure. Conclusion: The findings indicate that the patients with extensive flame burns were prone to developing septicaemia due mainly to gram-positive bacteria. The surgical excision of eschar and wound covering improved the outcome of the patients while prophylactic antibiotic treatment had no role in the incidence and outcome of the burn patients.

Epidemiology of Klebsiella pneumoniae bloodstream infections in a teaching hospital: factors related to the carbapenem resistance and patient mortality

“…reported that patients with ≥20% total body surface area burns show a higher risk of bacteremia [31], and Bang et al . found that the patients with extensive flame burns are prone to septicemia [32]. In our study,patients with KP-BSIs, with the infection source from skin and soft tissue, were accepted to the burn center of the hospital, and all suffered from flame injuries.…”

Matched Case-Control Analysis of Polymicrobial Bloodstream Infection In A Neonatal Intensive Care Unit

“…Polymicrobial BSI frequently occurs in adult and pediatric patients with serious underlying conditions. 12 " 16 ' 22,23 In adults, these conditions include cancer, 12 hospitalization in the intensive care unit, 13 chronic hemodialysis, 14 burns, 15 and acquired immune deficiency syndrome. 16 Reports of BSI in pediatric patients are less common, but associated underlying conditions are similar to those described in adults.…”

Incidence of methicillin resistant Staphylococcus aureus (MRSA) in burn intensive care unit: a systematic review

“…Of the 21 included studies, 13 were crosssectional studies and eight were cohort studies. These studies involved at least 8455 patients, primarily located in India (four studies), 2,[6][7][8] the USA (three studies), [9][10][11] China (two studies), 12,13 Iraq (two studies), 14,15 Kuwait (two studies), 16,17 and Sweden (two studies). 18,19 The other study populations were located in Ghana, 20 Iran, 21 Israel, 22 Lithuania, 23 Pakistan, 24 and Korea.…”