Risk Factors for Multidrug-Resistant Acinetobacter baumannii Infections in a Mass Burn Casualty Incident. 2019

Eng-Kean Yeong, and Wei-Lieh Huang
Department of Surgery, National Taiwan University Hospital, National Taiwan.

They investigated the risk factors of multidrug-resistant Acinetobacter baumannii infections in 33 burn patients in a mass burn casualty. The independent variables included sex, burn size, vancomycin, ampicillin/sulbactam, cefazolin, meropenem, third-/fourth-generation cephalosporin, the number of classes of antibiotic used, and the number of days of antibiotic use. Multidrug-resistant A. baumannii infection was the outcome variable. Logistic regressions and structural equation model were used for statistical analysis. The average age was 21.7 years (range, 17-32 years; M = 11 [33%], F = 22 [67%]; mean burn area, 42% of the total body surface area; study period, June 28, 2015 to July 31, 2015). The incidence of infection was 39% (n = 13/33). For every percent increase in burn size, the odds of developing A. baumannii infections increased by 1.1 (P < .05). Similarly, the odds increased by 2.5 in every number increase in the classes of antibiotic used, by 1.2 in everyday increase in the days of antibiotic used, and by 12 in patients treated with vancomycin (P < .05). The correlations of these risk factors were demonstrated in a hypothetical structural equation model (P-value of chi-squared test > .05 and root mean square error of approximation < 0.05) in which burn size was the fundamental risk factor of multidrug-resistant A. baumannii infections. The model did not predict the emergence of multidrug-resistant A. baumannii infections. Conclusively, the risks of multidrug-resistant A. baumannii infections in burns are correlated with burn size, the number of classes of antibiotic used, the number of days of antibiotic use, and the prior use of vancomycin.

UI MeSH Term Description Entries
D008297 Male Males
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000151 Acinetobacter Infections Infections with bacteria of the genus ACINETOBACTER. Mimae Infections,Infections, Acinetobacter,Infections, Mimae,Acinetobacter Infection,Infection, Acinetobacter,Infection, Mimae,Mimae Infection
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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