Universal contact precautions do not change the prevalence of antibiotic resistant organisms in a tertiary burn unit.pdfVIP
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Universal contact precautions do not change the prevalence of antibiotic resistant organisms in a tertiary burn unit.pdf
burns 43 (2017) 265–272
Available online at
ScienceDirect
journal homepage: /locate/burns
Universal contact precautions do not change the prevalence of antibiotic resistant organisms in a tertiary burn unit$
Adelyn L. Ho a, Reid Chambers b, Claudia Malic b, Anthony Papp a,*
a UBC Division of Plastic Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada b Division of Plastic Surgery, University of Ottawa, Ontario, Canada
article info
Article history: Accepted 1 November 2016
Keywords: Burns Antibiotic-resistant organisms Contact precautions Infection Colonization
abstract
Objective: The prevalence of antibiotic-resistant organisms (ARO) in burn units is increasing worldwide and contributes significantly to morbidity and mortality. Study aims are to describe the burden of AROs in burn patients admitted to a tertiary burn unit, to evaluate the impact of contact precautions implemented after an outbreak of antibiotic-resistant Acinetobacter baumannii, and to identify possible predictors of ARO acquisition. Methods: Data of burn inpatients between 2006 and 2010 were retrospectively reviewed. The antibiotic susceptibility profiles of ARO colonization/infection at or after admission were reviewed in detail. Organisms of interest included: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum beta-lactamase-producing Escherichia coli, and carbapenem-resistant Pseudomonas and Acinetobacter. Univariate and multivariate logistic regression analysis was employed with the p-value set at 0.05. Results: Complete data analysis was available for 340 patients. The mean age was 41.8 years with male predominance. Among the AROs, the most prevalent was MRSA from clinical specimens. Prior to contact precaution implementation, the prevalence of all AROs was 27.9%, compared to 27.6% afterwards. There was an increase in Pseudomonas and VRE isolates and a disappearance of Acinetobacter. The most common isolate sites
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