Гнойно-септические инфекции у пациентов с тяжелой ожоговой травмой. Этиология, распространенность, факторы риска

Abstract

Objective. To assess epidemiological characteristics of purulent septic infections (PSIs) in the intensive care unit (ICU) of a burn center. Patients and methods. In this retrospective epidemiological study, we analyzed medical records of 399 patients with burn injuries and the results of laboratory testing (2,572 samples). The majority of ICU patients were men aged 30–39 years. Almost half of the patients were workers. Burns were primarily caused by an open flame and were mainly received at home. Of note, 45.4% of patients who had burns caused by an open flame also had respiratory tract lesions. More than half of the patients had deep burns. A total of 18.6% of patients (95% CI 14.8–22.7) died. Results. The incidence of PSIs in the ICU of the burn center was 533,8‰ (95% CI 483.5–583.6), which is 2.5 times higher than that in the official statistics (210,1‰ (95% CI 182.5–239.9)). More than half of PSIs (50.2% (95% CI 43.3–57.1)) were burn wound infections. Conclusion. The following factors were found to be associated with an increased risk of PSIs: burn area >40%, burn severity index >30, SOFA score >4, deep burns, surgery, stay in the ICU for >10 days, artificial ventilation for >1 day, and placement of a central venous catheter or an urinary catheter for >1 day. Most frequently, PSIs were caused by non-fermenting gram-negative bacteria such as Pseudomonas аeruginosa and Acinetobacter baumannii. Key words: burn injury, purulent septic infections, risk factors, infection control