Petit Héloïse, de Tymowski Christian, Dudoignon Emmanuel, Liberge Mathilde, Donay Jean-Luc, Chaussard Maite, Coutrot Maxime, Cupaciu Alexandru, Guillemet Lucie, Deniau Benjamin, Pharaboz Alexandre, Benyamina Mourad, Denis Blandine, Mellon Guillaume, Lafaurie Matthieu, Alanio Alexandre, Dépret François, Berçot Béatrice, Caméléna François
Département de Bactériologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.
Département d'Anesthésie et Réanimation chirurgicale et brûlés, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.
Open Forum Infect Dis. 2025 Mar 12;12(4):ofaf151. doi: 10.1093/ofid/ofaf151. eCollection 2025 Apr.
Burns intensive care units (BICUs) have reduced mortality in patients with burns, but infections and sepsis remain the leading causes of death. Infections with multidrug-resistant (MDR) bacteria increase the risk of death in patients with burns, whose risk of acquiring such infections is higher due to various factors, including prolonged hospitalization and invasive procedures.
A retrospective study was performed in a French BICU over 8 years to analyze the epidemiology and risk factors for bloodstream infections (BSIs).
In total, 1402 patients were admitted to the BICU. Thermal burns were the most common cause of injury, and the median total body surface area burned was 10%. Patients had various comorbid conditions, particularly smoking and hypertension. BSI occurred in 303 (21%) patients. When compared with patients without BSI, patients with BSI were older, had higher severity scores and a larger total body surface area burned, and were more likely to develop complications. The prevalence of monomicrobial and polymicrobial BSI remained stable during hospitalization, with gram-positive pathogens such as most common during the first week but with gram-negative pathogens, particularly MDR , becoming more prevalent after 15 days. The distribution of microorganisms remained stable throughout the study, except for a significant decrease in rates and an increase in MDR rates after 2015.
An understanding of the epidemiology of BSI-causing microorganisms over time is crucial for sepsis management to ensure the selection of appropriate empirical antimicrobial therapy and to highlight the need for infection prevention and antimicrobial stewardship.
烧伤重症监护病房（BICUs）已降低了烧伤患者的死亡率，但感染和脓毒症仍然是主要的死亡原因。多重耐药（MDR）菌感染增加了烧伤患者的死亡风险，由于包括住院时间延长和侵入性操作等多种因素，烧伤患者获得此类感染的风险更高。
在一家法国BICU进行了一项为期8年的回顾性研究，以分析血流感染（BSIs）的流行病学和危险因素。
共有1402例患者入住该BICU。热烧伤是最常见的损伤原因，烧伤的中位全身表面积为10%。患者有各种合并症，尤其是吸烟和高血压。303例（21%）患者发生了BSI。与未发生BSI的患者相比，发生BSI的患者年龄更大，严重程度评分更高，烧伤的全身表面积更大，且更易发生并发症。住院期间，单一微生物和多微生物BSI的患病率保持稳定，革兰氏阳性病原体如 在第一周最为常见，但革兰氏阴性病原体，尤其是MDR ，在15天后变得更为普遍。除2015年后 率显著下降和MDR 率上升外，整个研究期间微生物的分布保持稳定。
了解导致BSI的微生物随时间变化的流行病学对于脓毒症管理至关重要，以确保选择合适的经验性抗菌治疗，并突出感染预防和抗菌药物管理的必要性。
