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Stochasticity among Antibiotic-Resistance Profiles of Common Burn-Related Pathogens over a Six-Year Period.

Abstract One of the most significant contributors to morbidity and death in patients with burns is infection, which accounts for 30%-75% of post-burn fatalities. Because of concerns for the development of antibiotic resistance in burn-related pathogens, the aims of this study were to identify antibiotic resistance trends for the four most common burn-related pathogens over a six-year period.
PMID
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Authors

Mayor MeshTerms

Drug Resistance, Bacterial

Keywords

Enterococcus faecalis

Pseudomonas aeruginosa

Staphylococcus aureus

antimicrobial management

burn sepsis

Journal Title surgical infections
Publication Year Start




PMID- 28394746
OWN - NLM
STAT- MEDLINE
DA  - 20170410
DCOM- 20170417
LR  - 20170417
IS  - 1557-8674 (Electronic)
IS  - 1096-2964 (Linking)
VI  - 18
IP  - 3
DP  - 2017 Apr
TI  - Stochasticity among Antibiotic-Resistance Profiles of Common Burn-Related
      Pathogens over a Six-Year Period.
PG  - 327-335
LID - 10.1089/sur.2016.191 [doi]
AB  - BACKGROUND: One of the most significant contributors to morbidity and death in
      patients with burns is infection, which accounts for 30%-75% of post-burn
      fatalities. Because of concerns for the development of antibiotic resistance in
      burn-related pathogens, the aims of this study were to identify antibiotic
      resistance trends for the four most common burn-related pathogens over a six-year
      period. PATIENTS AND METHODS: The study used prospectively collected and
      de-identified aggregate data for all burn patients admitted to the burn unit
      between 2009 and 2014. The database query included patient demographics along
      with all data regarding cultures from any source (wound, sputum, urine, stool,
      blood), which included isolated pathogens and antibiotic resistance profiles.
      Profiles were then constructed using mean inhibitory concentration standards to
      determine whether each pathogen was susceptible (S), intermediate (I), or
      resistant (R) to each antibiotic. The aggregated data were then used to construct
      a heat map for the four most common pathogens and their resistance profiles over 
      the six-year study period. RESULTS: There were 368 patients with burns (248 with 
      positive cultures, 120 with negative cultures) in this study. The positive
      culture group was significantly older (38 vs. 25 y, p < 0.001) and had longer
      hospitalizations (17 vs. 11 d, p < 0.01) compared with the negative group.
      Analysis of antibiotic resistance heat maps constructed for the four most
      commonly isolated pathogens (methicillin-sensitive Staphylococcus aureus,
      Enterococcus faecalis, methicillin-resistant S. aureus, Pseudomonas aeruginosa)
      indicated a lack of notable resistance patterns for any of the individual
      pathogens. CONCLUSIONS: Taken together, these results indicate that there are no 
      discernible patterns of antibiotic resistance across time (six years) for the
      four most common burn-related pathogens. We conclude that antibiotic choice in
      burn patients based on previous in-hospital trends may be a flawed strategy.
      Emerging genomic technology to deliver point-of-care pathogen-specific antibiotic
      sensitivities via polymerase chain reaction may be needed to more appropriately
      guide antibiotic choice.
FAU - Collier, Zachary J
AU  - Collier ZJ
AD  - 1 Pritzker School of Medicine, University of Chicago , Chicago, Illinois.
FAU - Gottlieb, Lawrence J
AU  - Gottlieb LJ
AD  - 1 Pritzker School of Medicine, University of Chicago , Chicago, Illinois.
AD  - 2 Department of Surgery, University of Chicago , Chicago, Illinois.
FAU - Alverdy, John C
AU  - Alverdy JC
AD  - 1 Pritzker School of Medicine, University of Chicago , Chicago, Illinois.
AD  - 2 Department of Surgery, University of Chicago , Chicago, Illinois.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170224
PL  - United States
TA  - Surg Infect (Larchmt)
JT  - Surgical infections
JID - 9815642
RN  - 0 (Composite Resins)
RN  - 0 (Profil)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bacteria/classification/*drug effects/isolation & purification
MH  - Bacterial Infections/epidemiology/*microbiology
MH  - Burns/*complications
MH  - Child
MH  - Cohort Studies
MH  - Composite Resins
MH  - *Drug Resistance, Bacterial
MH  - Female
MH  - Humans
MH  - Male
MH  - Microbial Sensitivity Tests
MH  - Middle Aged
MH  - Young Adult
OTO - NOTNLM
OT  - *Enterococcus faecalis
OT  - *Pseudomonas aeruginosa
OT  - *Staphylococcus aureus
OT  - *antimicrobial management
OT  - *burn sepsis
EDAT- 2017/04/11 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/04/11 06:00
AID - 10.1089/sur.2016.191 [doi]
PST - ppublish
SO  - Surg Infect (Larchmt). 2017 Apr;18(3):327-335. doi: 10.1089/sur.2016.191. Epub
      2017 Feb 24.

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