Morbidity and Mortality of Bloodstream Infections in Patients With Severe Burn Injury

Brusselaers, Nele; Monstrey, Stan; snoeij, t; Vandijck, Dominique; Lizy, Christelle; Hoste, Eric; Lauwaert, S.; Colpaert, Kirsten; Vandekerckhove, Linos; Vogelaers, Dirk; Blot, Stijn

doi:10.4037/ajcc2010341

Cited by 66 publications

(46 citation statements)

References 46 publications

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“…Recent reports have established that nosocomial strains of P. aeruginosa are frequently multi-drug resistant and that their prevalence is increasing worldwide, especially in high-risk populations [39,40]. Clinical treatment schedule for suspected pneumonia always include antibiotics and especially Meropenem which is the prototypal anti-pseudomonas antibiotic.…”

Section: Discussionmentioning

confidence: 99%

The Anti-Pseudomonas aeruginosa Antibody Panobacumab Is Efficacious on Acute Pneumonia in Neutropenic Mice and Has Additive Effects with Meropenem

et al. 2013

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Pseudomonas aeruginosa (P. aeruginosa) infections are associated with considerable morbidity and mortality in immunocompromised patients due to antibiotic resistance. Therefore, we investigated the efficacy of the anti-P. aeruginosa serotype O11 lipopolysaccharide monoclonal antibody Panobacumab in a clinically relevant murine model of neutropenia induced by cyclophosphamide and in combination with meropenem in susceptible and meropenem resistant P. aeruginosa induced pneumonia. We observed that P. aeruginosa induced pneumonia was dramatically increased in neutropenic mice compared to immunocompetent mice. First, Panobacumab significantly reduced lung inflammation and enhanced bacterial clearance from the lung of neutropenic host. Secondly, combination of Panobacumab and meropenem had an additive effect. Third, Panobacumab retained activity on a meropenem resistant P. aeruginosa strain. In conclusion, the present data established that Panobacumab contributes to the clearance of P. aeruginosa in neutropenic hosts as well as in combination with antibiotics in immunocompetent hosts. This suggests beneficial effects of co-treatment even in immunocompromised individuals, suffering most of the morbidity and mortality of P. aeruginosa infections.

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Section: Discussionmentioning

confidence: 99%

The Anti-Pseudomonas aeruginosa Antibody Panobacumab Is Efficacious on Acute Pneumonia in Neutropenic Mice and Has Additive Effects with Meropenem

et al. 2013

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“…Despite improvements in early treatment, long-term survival remains challenged, mainly due to sepsis 7 and multiple organ dysfunction syndrome (MODS). 8,9 Accordingly, sepsis and MODS are currently the leading causes of death in both pediatric 8 and adult burn patients. 9 …”

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confidence: 99%

“…8,9 Accordingly, sepsis and MODS are currently the leading causes of death in both pediatric 8 and adult burn patients. 9 …”

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confidence: 99%

“…The combination of an impaired immune response characterized by decreased T-cell function following injury, 15 a disruption of the protective skin barrier from burn injury 16 allowing pathogens to spread easily throughout the rest of the body, and long hospitalizations with multiple surgical procedures and the use of catheters and other invasive devices places burn patients at an increased risk of infectious complications. 9 …”

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confidence: 99%

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Multiple-Drug Resistance in Burn Patients

Langeveld

Gagnon

Conrad

et al. 2017

Journal of Burn Care & Research

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Despite improvements in early treatment, survival following burn injury remains challenged by sepsis and multiple organ dysfunction syndrome (MODS). Additionally, susceptibility to infections and growing antibiotic resistance places burn patients at increased risk for infections with multiple-drug resistant organisms (MDROs). We therefore aimed to evaluate the impact of MDRO infections on survival and hospital length of stay, as well as examine the role of these organisms in the development of complications, such as acute kidney injury, sepsis, and MODS. To study this, we included all burn patients with infections, admitted between January 1, 2012, and December 31, 2013. Patients were divided into two groups: patients with infections caused by MDROs and patients with infections caused by susceptible organisms. Data were collected on all available cultures, as well as demographic, injury, and treatment-related variables from the medical record. The number of operative procedures (median: 2 vs 1, P < .0001), ventilator days (21 vs 0 days, P < .0001), total antibiotic days (21 vs 7days, P < .0001), and length of hospitalization (39 vs 14 days, P < .0001) were significantly different in the MDRO group vs the nonresistant group. While MDRO infection was not associated with patient mortality, univariable logistic regression analyses demonstrated >20% TBSA (odds ratio [OR] = 4.30, 95% confidence interval [CI]: 1.14–16.29, P = .03), acute kidney injury (OR = 10.93, 95% CI: 2.74–43.57, P = .001), sepsis (OR = 19.20, 95% CI: 3.79–97.27, P < .001), and MODS (OR = 85.49, 95% CI: 12.97–563.28, P < .0001) significantly increased the odds of patient mortality. These findings suggest that infections with MDROs are associated with a greater number of surgical procedures, longer duration of mechanical ventilation, more antibiotic days, and longer hospitalization.

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“…[51][52][53][54] Consequently, strict adherence to a protocol for glycemic control is pivotal. 55 The effect of an educational intervention on ICU nurses' knowledge about glycemic control was assessed by means of a beforeafter study.…”

Section: Agitation Confusion and Deliriummentioning

confidence: 99%

Recent Advances in Multidisciplinary Critical Care

Blot

Afonso

Labeau

2015

American Journal of Critical Care

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The intensive care unit is a work environment where superior dedication is crucial for optimizing patients' outcomes. As this demanding commitment is multidisciplinary in nature, it requires special qualities of health care workers and organizations. Thus research in the field covers a broad spectrum of activities necessary to deliver cutting-edge care. However, given the numerous research articles and education activities available, it is difficult for modern critical care clinicians to keep up with the latest progress and innovation in the field. This article broadly summarizes new developments in multidisciplinary intensive care. It provides elementary information about advanced insights in the field via brief descriptions of selected articles grouped by specific topics. Issues considered include care for heart patients, mechanical ventilation, delirium, nutrition, pressure ulcers, early mobility, infection prevention, transplantation and organ donation, care for caregivers, and family matters.

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Morbidity and Mortality of Bloodstream Infections in Patients With Severe Burn Injury

Cited by 66 publications

References 46 publications

The Anti-Pseudomonas aeruginosa Antibody Panobacumab Is Efficacious on Acute Pneumonia in Neutropenic Mice and Has Additive Effects with Meropenem

The Anti-Pseudomonas aeruginosa Antibody Panobacumab Is Efficacious on Acute Pneumonia in Neutropenic Mice and Has Additive Effects with Meropenem

Multiple-Drug Resistance in Burn Patients

Recent Advances in Multidisciplinary Critical Care

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