Saraswati P A, Saputro I D, Widodo A D W, Budi A S, Permana P B D
Medical Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Department of Reconstructive and Aesthetic Plastic Surgery, Dr. Soetomo General Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Ann Burns Fire Disasters. 2025 Jun 30;38(2):124-135. eCollection 2025 Jun.
Burn injuries have a relatively high prevalence in Indonesia, and infection, as one of the serious complications, can significantly increase the risk of morbidity and mortality in patients. This study aimed to investigate the bacteriological profile, antimicrobial susceptibility pattern, and clinical outcomes of burn patients with bloodstream infection (BSI) in Indonesia. A retrospective cohort design was employed from January 2019 to December 2021 using secondary data from the patients' medical records. Factors associated with length of stay (LoS) and in-hospital mortality were evaluated through Mann-Whitney/Kruskal-Wallis test and chi square/Fisher's exact test, respectively. A total of 43 burn patients with culture-proven bloodstream infections were included in the analysis. Gram negative bacteria were the most commonly isolated pathogens (61.9%), with being the primary species (34.9%). Coagulase-negative Staphylococci (CoNS) was the second most common species (26.9%), accounting for the majority of gram-positive bacteria. Carbapenem non-susceptibility was remarkably high in gram-negative bacteria, with piperacillin-tazobactam, amikacin, and tetracycline offering higher activity. The presence of other coinfections apart from BSI was significantly associated with prolonged LoS (p=0.039). Factors associated with in-hospital mortality include flame burns (p=0.041), TBSA ≥40% (p=0.003), and early BSI of <7 days (p=0.046). However, no difference in LoS or mortality was demonstrated in patients with infection compared to CoNS. Prolonged length of stay and increased risk of mortality necessitates clinicians to further improve infection control within the burn unit and evaluate prudent use of antibiotics for patients.
烧伤在印度尼西亚的发病率相对较高，而感染作为严重并发症之一，会显著增加患者发病和死亡的风险。本研究旨在调查印度尼西亚血流感染（BSI）烧伤患者的细菌学特征、抗菌药物敏感性模式及临床结局。采用回顾性队列设计，利用2019年1月至2021年12月患者病历中的二手数据。分别通过Mann-Whitney/Kruskal-Wallis检验和卡方/Fisher精确检验评估与住院时间（LoS）和院内死亡率相关的因素。共有43例经培养证实为血流感染的烧伤患者纳入分析。革兰氏阴性菌是最常见的分离病原体（61.9%），其中 是主要菌种（34.9%）。凝固酶阴性葡萄球菌（CoNS）是第二常见菌种（26.9%），占革兰氏阳性菌的大多数。革兰氏阴性菌对碳青霉烯类药物的不敏感性非常高，哌拉西林-他唑巴坦、阿米卡星和四环素的活性较高。除BSI外的其他合并感染与住院时间延长显著相关（p=0.039）。与院内死亡率相关的因素包括火焰烧伤（p=0.041）、总体表面积（TBSA）≥40%（p=0.003）和烧伤后7天内发生的早期BSI（p=0.046）。然而，与CoNS感染患者相比， 感染患者的住院时间或死亡率没有差异。住院时间延长和死亡风险增加使得临床医生有必要进一步加强烧伤病房的感染控制，并评估对患者谨慎使用抗生素的情况。
