AUTHOR=Gong Yali , Peng Yuan , Luo Xiaoqiang , Zhang Cheng , Shi Yunlong , Zhang Yixin , Deng Jun , Peng Yizhi , Luo Gaoxing , Li Haisheng 

TITLE=Different Infection Profiles and Antimicrobial Resistance Patterns Between Burn ICU and Common Wards

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2021.681731

DOI=10.3389/fcimb.2021.681731

ISSN=2235-2988

ABSTRACT=Abstract
Infection is the leading cause of complications and deaths after burns. However, the difference of infection pattern between burn intensive care unit (BICU) and burn common wards (BCW) have not been clearly investigated. The present study aimed to compare the infection profile, antimicrobial resistance and their changing patterns of burn patients in BICU and BCW. Clinical samples were analyzed between 1 January, 2011 and 31 December, 2019 in Institute of Burn Research in Southwest China. The patient information, pathogen distribution, sources and antimicrobial resistance were retrospectively collected. A total of 3,457 and 4,219 strains were detected in BICU and BCW, respectively. Wound secretions accounted for 86.6% and 44.9% in BCW and BICU, respectively. Compared with samples in BCW, samples in BICU had more fungi (11.8% VS 8.1%), more gram-negative bacteria (60.0% VS 50.1%) and less gram-positive bacteria (28.2% VS 41.1%). Acinetobacter baumannii were the most common pathogen in BICU, compared to Staphylococcus aureus in BCW. S. aureus was the most frequent pathogen in wound secretions and tissues from both BICU and BCW. However, A. baumannii were the first in bloods, sputum and catheter samples from BICU. Overall, the multi-drug resistant (MDR) rate were higher in BICU than in BCW. However, the gap between BICU and BCW gradually shortened from 2011 to 2019. The prevalence of MDR A. baumannii and Klebsiella pneumonia significantly increased, especially in BCW. Furthermore, Carbapenem resistance among K. pneumoniae significantly increased in BICU (4.5% in 2011 VS 40% in 2019) and BCW (0 in 2011 VS 40% in 2019). However, the percentage of MDR P. aeruginosa sharply dropt from 85.7% to 24.5% in BICU. The incidence of MRSA was significantly higher in BICU than in BCW (94.2% vs 71.0%) and kept at high level in BICU (89.5% to 96.3%). C. tropicalis and C. albicans were the two most frequent fungi. No resistance to Amphotericin B were detected. Our study showed that infection profile was different between BICU and BCW, and the multidrug resistance was more serious in BICU than BCW. Therefore, different infection control strategies should be emphasized in different burn populations.