Infections In Burn Patients Research Articles

Detection of OXA-23, OXA-48, OmpA and bla-TEM genes in carbapenem-resistance Acinetobacter baumannii and biofilm formation in burn patients at Al-Anbar Government

Background. Antibiotic-resistant bacteria represent a highly global health issue by causing high rates of morbidity and mortality in burn units, whereas biofilms significantly contribute to complications in burn patients. Objectives. The study investigates the prevalence of (OXA-23, OXA-48, OmpA and bla-TEM) and biofilm formation of Acinetobacter baumannii in the Burn Unit of the Al-Anbar government. Methods. A total of 120 clinical swab samples from burn patient were collected from December 2023 to April 2024 from the burn units of Ramadi Teaching Hospital and Falluja Teaching Hospital for the study. The colonies were identified using conventional and Vitek methods. Colorimetric technique (MTP) and multiplex PCR were used to detect biofilms and resistance genes. Results. Among 120 samples, 40 (33.3%) were Acinetobacter baumannii, 34 (80%) were MDR- resistant, and 6 (15%) were XDR. 90% of the isolates were resistant to Cefotaxime, and Colistin was more sensitive in all forty isolates. All 40 isolates formed significant biofilms. The percentage of positive results for OXA-23, OmpA and bla-TEM genes were 80%, 65%, and 55% of respectively. Carbapenem testing is essential to identify carbapenem-producing strains from non-producing strains due to the high prevalence of multidrug-resistant A. baumannii with the OXA-23 and OmpA genes. Conclusion. These findings highlight the urgent need for effective infection control measures and the development of new therapeutic strategies to manage these infections in burn patients.

Association of length of hospital stay, total body surface area burned, and Carbapenem-Resistant Klebsiella pneumoniae infection in burn patients: A retrospective study

BackgroundThe specific relationships between total body surface area burned (TBSA), length of stay (LOS), and carbapenem-resistant Klebsiella pneumoniae (CRKP) infection remain unclear. This study aimed to explore the relationship between TBSA and CRKP infection and to examine whether LOS mediates the association between TBSA and the risk of CRKP infection. MethodsWe retrospectively collected the clinical data of adult burn patients admitted to Nanyang Nanshi Hospital between 2021 and 2023. We used multivariate logistic regression analysis to study the risk factors for CRKP infection; restricted cubic spline analysis to investigate the associations between TBSA, LOS, and CRKP infection; and mediation analysis to examine whether LOS mediated the association between TBSA and CRKP infection. ResultsA total of 178 subjects were included in the study; 104 (58.4 %) were male, and the median age was 47 (33−59) years. Thirty-one (17.4 %) subjects developed CRKP infection. Both TBSA and LOS showed a linear positive correlation with the risk of CRKP infection. The LOS mediated the association between TBSA and incident CRKP infection, with a proportion of 17.6 %. ConclusionThe risk of CRKP infection linearly increased as TBSA or LOS increased, and LOS mediated approximately 20 % of the total association between TBSA and CRKP infection.

Meta-Analysis of the Global Mortality Rate Due to Infection in Burn Patients Admitted for Plastic Surgery.

Burn patients are generally prone to infection, which causes the patient's condition to be even worse. However, there is no study regarding the difference between the mortality rate of infected and non-infected patients. Therefore, the aim was to identify and compare the global mortality rate between infected and non-infected patients who were admitted to plastic surgery units. We searched PubMed, ScienceDirect, and Google Scholar and finally included five articles for this meta-analysis.We determined the odds ratio (OR) value by forest plot and assessed the study bias by a funnel plot. We also analyzed the quality and heterogeneity. The OR was determined as 0.43 (95%CI: 0.07-2.60), indicating a higher mortality rate in infected burn patients as compared to non-infected patients. The funnel plot showed no significant study bias. The quality of the studies was assessed high as well, and the heterogeneity was determined significant (I2>75%). The sensitivity analysis with the fixed effect model reconfirmed our main outcome. However, as a study limitation, we could not specifically determine the impact of strain-specific infection on the mortality rate and could not find more relevant research regarding this issue. We conclude that the overall non-infected burn patient mortality rate is lower as compared to the infected burn patients; however, non-infected patients can be prone to death if the burn degree is higher, the respiratory organ is injured, or the treatment is poor or delayed.

Multi-state evaluation of Candida infections in burn patients.

Burn patients are at high risk of developing secondary invasive fungal infections due to their compromised skin barrier, extensive use of antibiotics, and immunosuppression. We investigated demographic characteristics and clinical factors associated with Candida infections in intensive care unit (ICU) burn patients, and the invitro antifungal susceptibility of species of isolates. A total of 353 burn patients admitted to three major ICUs of burn centers in Iran were evaluated between 2021 and 2023. Patients were considered as colonisation and candidemia. Demographic characteristics, burn-related factors, and clinical conditions were compared among the groups. Furthermore, we identified fungi at the species level and performed antifungal susceptibility testing according to CLSI guidelines. Overall, 46.2% of patients were colonised with a Candida species, leading to candidemia in 15.3%. The most frequently isolated species from candidemia and burn wound colonisation were Candida parapsilosis (37.0%) and Candida albicans (31.9%), respectively. Risk factors linked to candidemia included larger total body surface area (TBSA) (>50%), older patients, indwelling catheters, diabetes, and an extended ICU stay. Mortality rate was higher among candidemia patients (82.5%) compared to colonised patients (7.3%). The resistance rate of the strains isolated from candidemia to fluconazole and voriconazole was 28% and 18.2%, respectively. We found that a higher percentage of TBSA burn injuries, longer hospital stays, and catheterization are important predictors of candidemia. The mortality rate was significantly higher in people infected with non-albicans Candida species. Prevention and treatment strategies for candidemia should be based on updated, regional epidemiological data.

The predictive role of Interleukin 6 and Procalcitonin associated with bacterial infection causing sepsis in patients with severe burn

Background. Sepsis is a major contributor to both death and illness on a worldwide scale. Bacteremia characterized by the presence of gram-negative, gram-positive, or mixed growth bacteria has been shown to be associated with a significantly increased risk of septic shock and a bad prognosis. Biomarkers are used to aid in the diagnosis of sepsis and to differentiate between bacterial causes, namely Gram-negative, Gram-positive, and mix growth bacteria. Objectives. This study aimed to evaluate the role of PCT and IL-6 in predicting bacterial infection in burn patients with sepsis due to gram-negative, gram positive and mixed growth bacteria. Methods. Forty-four patients with age (1.5–75 years), and nineteen healthy controls with the same age range, were involved in this study during their attendance to Specialized Burns Hospital in the Medical City, Al-Kindi Teaching Hospital in Baghdad, and Al-Nasiriyah General Hospital in Thi-Qar province. The study was conducted from 1st December 2023 to 1st April 2024 and approved by ethical committees of Institute of Genetic Engineering and Biotechnology for Postgraduate Studies/ Baghdad University. Blood samples and data were collected to evaluate the level of PCT and IL-6 associated with bacterial infection for burn patients by enzyme linked immunosorbent assay (ELISA). Results. 25 (50%) showed growth for Gram-negative, 13 (26%) for Gram-positive and 12 (24%) for mix growth bacteria. Results appeared a significant increase at (P≤0.01) in each of PCT and IL-6 in burn patients to control group according to gender. Patients exhibiting a combination of bacterial growth have notably elevated levels of procalcitonin (PCT). Levels of PCT were significantly elevated in burn patients with mixed growth sepsis compared to patients with Gram-negative and Gram-positive sepsis. However, there were no significant differences in IL-6 levels between burn patients with mix growth sepsis and patients with gram-negative and gram-positive sepsis (P> 0.05). Measuring PCT levels may assist in selecting the appropriate empirical antibiotic treatment. Conclusions. The PCT biomarker demonstrated superior performance in distinguishing between microbial sepsis caused by various kinds of pathogens. This finding has great promise for its use in clinical practice, particularly in burn units.

Evaluation of White Blood Cell Count, Lymphocyte Percentage, Neutrophil Percentage, and Elevated Temperature as Predictors of Wound Infection in Burn Patients.

Infection remains a chief cause of morbidity and mortality among burn patients. The burn wound surface is initially sterile after a thermal injury but eventually gets colonized by microorganisms. A burn wound is considered infected upon the presence of high concentrations of microorganismsin the wound and scab. Burn wound infections can lead to a delay in epidermal maturation, higher scar formation, and sepsis. However, burn patients are commonly misclassified as septic due to the manifestation of systemic inflammatory response syndrome (SIRS) after their injury, despite the presence or absence of an infection. This is a retrospective review of medical records of patients admitted to the burn unit in Salmaniya Medical Complex in Manama, Bahrain, between the years 2018 and 2020. Demographic data, total body surface area (TBSA), initial temperature, white blood cell count, lymphocyte percentage, neutrophil percentage, and wound cultures were obtained for all subjects. Logistic regression analysis was performed to compare the presence or absence of wound infection by the aforementioned parameters. Of 412 cases, 68.2%were male patients, with a mean age for the studied population of 25.1 years (standard deviation (SD)=20.7). Staphylococcus aureus was the most prevalent organism across all of the study population (n=31)(34.4%). Staphylococcus aureus was the most prevalent organism in patients under the age of five, while Pseudomonas aeruginosa was the most common organism among adults older than 65 years of age. TBSAwas not found to be a good predictor of wound infection. There was no statistically significant relation between initial temperature and wound culture (p-value=0.056). However, logisticregression revealed that the initial temperature increases the likelihood of positive wound culture by almost three times. White blood cell count, lymphocyte percentage, and neutrophil percentagewere not clinically reliable in predicting burn wound infection. However, initial temperature might be a helpful predictor. Further research is needed to identify reliable clinical parameters of burn wound infections.

Clinico Microbiological Study of Infection In Burn Patients at BPKIHS Teaching Hospital

Background: Each year around 2,00,000 peoples globally are injured by burn and 1,00,000 of these seek medical attention out of which 10,000 lose their lives. prevention is better in burns. The exact data about burns patient in Nepal is not known. Methods: Prospective observational study carried out at surgical ward of BPKIHS Teaching Hospital between 15 May 2001 to 14 May, 2002 i.e. one year altogether. Results: There were total 95 cases of burn patients admitted and managed by BPKIHS Teaching Hospital during that periods. Males were 40% (38) and Females were 60% (57). Accidental burns injury was 90.55% (86) and flame burns were 83% (79). Mixed infection in 36%, Acinobacter in 32% and pseudomonas in 14.4% found in wound swab cultures. Ofloxacin was found sensitive in 91.6%. 27% (26) patients expired in our study. Conclusion: Mortality is high in our study because of Major burn patients came late in our Teaching Hospital for treatment.

Nutritional Interventions to Improve Immune Function and Reduce Infection Rates in Burn Patients

This prospective interventional study investigated the impact of individualized nutritional interventions on immune function and infection rates in burn patients. This study enrolled 120 burn patients between December 2022 and January 2024. The nutritional interventions focused on protein supplementation, micronutrient replenishment, and inclusion of anti-inflammatory nutrients, specifically omega-3 fatty acids and vitamin C. The nutrients were administered through oral, enteral, and parenteral routes based on dietary preferences and the medical condition of individuals. Protein was prioritized because of its role in leukocyte production; zinc and vitamin C were supplemented to optimize immune function; and omega-3 fatty acids were included to mitigate inflammation and enhance wound healing. The study assessed outcomes through changes in leukocyte and lymphocyte counts, cytokine levels, infection rates, wound healing rates, and the length of hospital stays. Results indicated significant improvements in immune markers and reduced infection rates post-intervention (P < 0.05). Leukocyte count increased significantly, cytokine levels decreased, and the infection rate reduced from 30% to 14.2% (P < 0.05). These outcomes highlighted the efficacy of targeted nutritional interventions in supporting immune health and reducing infections in burn patients. The findings advocated for integrating comprehensive nutritional strategies in managing burn injuries to improve clinical outcomes.

Infection control and prevention in burn victims: The role of nurses

ABSTRACT Burn injury is a major public health concern, with an estimated 180,000 deaths each year associated with burn-related infections. The majority of these occur in low- and middle-income countries, and almost two-thirds occur in the World Health Organization African and South-East Asia Regions. There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years. Hence, this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims. This review analyzed published studies using keywords such as burn injury, infection in burn patients, and nurses’ involvement in infection prevention and control (IPC) on search engines such as PubMed, Science Direct, and Google Scholar. The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective; the date range chosen in the literature search was from 2015 to 2023. The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control. The study also found that nurses’ responsibilities include proper hand hygiene, wound care, the use of personal protective equipment, antibiotic medication, cleaning the patient’s surroundings, and preventing patient cross-contamination. Burn injuries pose a significant risk to patients, necessitating infection control and prevention. Therefore, nurses in burn units should be informed on IPC practices and also educate patients, families, and coworkers on their importance.

Co-occurrence of blaNDM-1 and blaOXA-23 in carbapenemase-producing Acinetobacter baumannii belonging to high-risk lineages isolated from burn patients in Tunisia.

Carbapenem-resistant Acinetobacter baumannii (CR-Ab) is an important cause of infections in burn patients. This study aimed to characterize the antimicrobial susceptibility pattern of CR-Ab isolated from burns in Burn Intensive Care Unit (BICU) of the Trauma and Burn Centre of Ben Arous, to determine the prevalence of β-lactamase-encoding genes and to search eventual genetic relatedness of CR-Ab strains. From 15 December 2016 to 2 April 2017, all nonduplicated CR-Ab isolated in burn patients in the BICU were screened by simplex Polymerase Chain Reaction (PCR) for the class A, B, C, and D β-lactamase genes. Sequencing was performed for NDM gene only. Genetic relatedness was determined by using pulsed field gel electrophoresis (PFGE) and by multilocus sequence typing. During the study period, 34 strains of CR-Ab were isolated in burns, mainly in blood culture (n=14) and central vascular catheter (n=10). CR-Ab strains were susceptible to colistin but resistant to amikacin (91%), ciprofloxacin (100%), rifampicin (97%), and trimethoprim-sulfamethoxazole (100%). All strains harbored blaOXA-51-like and blaOXA-23 genes, only or associated to blaGES (n=26; 76%), blaADC (n=20; 59%), blaPER-1 (n=6; 18%) or/and blaNDM-1 (n=3; 9%). PFGE identified 16 different clusters and revealed that most strains belonged to one major cluster A (n=15; 44.1%). Among NDM-1 isolates, two were clonally related in PFGE and belonged to two single locus variant sequence type ST-6 and ST-85. This is the first description of clonally related NDM-1 and OXA-23-producing A. baumannii strains in the largest Tunisian BICU associated with two single locus variant sequence types ST6 and ST85.

Common Resistance Patterns in the Burn Unit of a Tertiary Care Center: A Retrospective Observational Study.

Background Nosocomial bacterial infections have been one of the major concerns in the healthcare system. Burn patients, specifically severe cases, are at a high risk of developing bacterial infections compared to others. The most frequent cultures among burn patients are Staphylococcus aureus, Pseudomonas aeruginosa,and Acinetobacter baumannii. There is a scarcity of local data showing the most common infections in burn patients. This research aimed to determine the most common organisms that cause infections in burn unit patients and the antibiotic sensitivity and resistance patterns in King Abdulaziz Medical City (KAMC) in Jeddah. Methodology In this cross-sectional study, data were collected from patients' files into a data collection sheet. All patients in the burn unit with a positive culture were included in the study using a convenient sampling technique from Best-Care, KAMC electronic medical records. Burn patients with negative culture results and patients who were admitted to the plastic surgery ward for reasons other than burns were excluded. For sample size calculation, convenience sampling of 109 patient medical charts, over the study period from June 2016 to November 2021, was selected for data extraction, analysis, and reporting. Results Pseudomonas aeruginosa was the leading cause of infection in burn patients comprising 33.9% of the cases. Enterobacter cloacae was the second most frequent cause of infection among burn patients (27.5%). Klebsiella pneumoniae was the third most frequent cause of infection (26.6%) while Acinetobacter baumannii was the fourth most frequent cause of infection in burn patients (22.9%). Conclusions Understanding the local epidemiology of bacterial infections will be crucial for the development of treatment guidelines designed to standardize initial antibiotic use, reduce hospital-acquired infections, and reduce drug resistance. More attention should be paid to gram-negative bacteria, specifically Pseudomonas aeruginosa and Enterobacter Cloacae.

Facteurs associés à une issue défavorable chez les brûlés hospitalisés

In 2015, Médecins Sans Frontières opened the Arche Kigobe Trauma Centre in Bujumbura, Burundi, to treat victims of violence, and in 2016 extended the admission criteria to burns, without a specialised unit to treat these. To study the factors associated with an unfavourable outcome (death, referrals and discharges against medical advice) in burn patients hospitalised at this centre. This is a retrospective descriptive and analytical study of hospitalised burn patients. From 2016 to 2020, 477 patients were hospitalised at the Centre for burns, of whom 301 (63%) were less than 5 years old, 169 (35%) were female, and 48 (10%) had an unfavourable outcome. Anaemia (OR 11, 95% CI 2.7-48), infection (OR 11, 95% CI 5.7-22), and smoke inhalation (OR 28, 95% CI 7-111) were among the main factors associated with an unfavourable outcome. To minimise adverse outcomes related to inhalation and infection in burn patients, a septic isolation circuit, training, a bacteriology service and continuous positive airway pressure could be implemented even in resource-limited settings.

Contactless methods to acquire heart and respiratory signals—A review

<p align="justify">The vital sign is the most important parameter for the internal health status of any subject in time. Every person is witnessed of COVID-19 global pandemic viruses. The world population has faced this problem globally. Collecting the infected person’s sample data in a contact-based approach may lead to the spreading of the disease. On the other hand, if we use a non-contact-based approach for the collection, it is somehow far better and breaks the chain of virus spreading. This radar-based technique is preferred in non-contact vital sign detection so that any person gets to their health status prior and according to that doctor can diagnose the proper treatment. The radar-based signal is targeted to the subject’s chest. Due to the chest wall displacement main vital sign parameters of the heart and respiration of the individual’s health are being captured. These captured signals are called vital signs, with this it is very helpful that the pre-diagnosis and treatment can be recommended by doctors or health service providers. Some patients due to their movement may be older or children for a long-time use skin irritation or allergy type of problems may face. On the other hand, some patients may be COVID-19 infected disease and burn patients. Hence, it is not possible to connect as both cases are unexpected for the required purpose. For constant and continuous measurement, existing contact-based methods are not fruitful hence non-contact-based approach is adopted. Non-contact-based vital sign detection is preferably due to several problems occurring. This paper presents a state-of-the-art review of recent monitoring methods and techniques for health monitoring in medical fields of operations. These methods and techniques are used as a tool to acquire, visualize and analyze the sampled data collected in any environment either indoor or outdoor.</p>

Infections in burn patients: Literature review

Burns are one of the most common and devastating types of trauma. Patients suffering from severe thermal injury require immediate specialized care to reduce morbidity and mortality.

Current status and research advances on catheter-associated urinary tract infection in burn patients

Catheter-associated urinary tract infection (CAUTI) is one of the common nosocomial infections in burn patients. It not only extends the length of hospital stay of patients, increases the economic burden on family and society, but also seriously affects the prognosis and quality of life of patients, increases the risk of death of patients. In this paper, the epidemiological characteristics, influencing factors, and prevention measures of CAUTI in burn patients are reviewed to draw high attention of clinical medical staff and to provide some reference for clinical practice.

Early wound excision within three days decreases risks of wound infection and death in burned patients

IntroductionIn lieu of limited studies on the timing of burn wound eschar excision for burns, a more comprehensive analysis is indicated to determine the effects of early wound excision following burns. This study aims to address the outcomes of early wound excision in burn patients. MethodsData collection were from TriNetX research database. Three groups of burn patients were stratified by the number of days in which they received burn wound excision within 14 days of injury. Five outcomes were observed: death, wound infection, sepsis, myocardial contractile dysfunction, and blood transfusion. Risk and incidence of various health outcomes were compared between the groups after propensity-matching age, sex, ethnicity, race and burn size using a z-test with p < 0.05 considered significant. ResultsWe identified 6158 burn patients with wound excision within 14 days of injury, the majority of whom (60.1%) received burn wound excision between 0 and 3 days after burn. 72.5% of patients had burns covering less than 20% of total body surface area. After propensity matching, we found a significantly lower risk of mortality in those who received burn wound excision within the first three days (3.84%) as compared to 8–14 days after burn (6.09%) (p < 0.05). Moreover, we found a decreased risk of wound infection in patients with burn wound excision within 0–3 days (37.84%) compared to those 4–7 days (42.48%) (p < 0.05). No statistical difference was detected in propensity-matched groups for myocardial contractile dysfunction, blood transfusion, or sepsis. In addition, the risk of hypertrophic scaring significantly decreased when wound excision was performed within 0–3 days (22% within 0–3 days, 28% within 4–7 days, p < 0.05). ConclusionBurn wound excision within 3 days of injury is beneficial when comparing to later treatment between 4 and 14 days, which results in a significantly lowered risk of mortality and infection in burn patient.

551 Reduction of Fungus-Related Complications in a Burn Center

Abstract Introduction Fungal wound infections (FWI) cause morbidity and increase mortality in burn patients. Our burn center experienced 44 patients with fungal wound colonization (FWC) and/or FWI between JAN 2015 and JAN 2019. In response, we undertook a performance improvement project to prevent and treat FWC and FWI. Methods Members of the multidisciplinary team met to develop a clinical practice guideline (CPG) for the prevention and management of FWC and FWI based on current evidence. We focused on patients with elevated risk, that is, with burns ≥20% total body surface area (TBSA) and in the Burn ICU (BICU). Interventions included: utilizing alternating silver sulfadiazine and mafenide acetate creams upon admission; reducing the use of mafenide acetate solution; utilizing silver nitrate solution post-operatively; and applying topical nystatin cream or powder for suspected FWC or FWI. We educated all staff members and updated order sets and training materials. We collected data on all burn patients who had a wound biopsy out of concern for possible infection. Biopsy results were categorized as FWC or FWI. Retrospective data were collected for MAR 2020 - MAR 2021 (PRE). Post-implementation, prospective data collection began MAR 2022 (POST) and will continue for one year. Adherence to the CPG was assessed by chart review. Mann-Whitney and Fischer Exact tests were performed. Results The PRE (n=15) and POST (n=9) groups were similar in age (43±13 vs. 48±18 years) but differed in TBSA (49±19 vs 28±25%, p&amp;lt; .05). PRE group biopsies showed FWC in 0 patients and FWI in 11 of 15 patients (73%); 8 of these (53%), all with FWI, died. In the POST group, FWC was found in 1 patient (11%) and FWI was found in 2 of 9 patients (22%); one death occurred in the patient with FWC. Adherence to the CPG for admission topical wound care was 7% in the PRE group vs 89% in the POST group (p=0.0001); adherence to the CPG for day-of-biopsy topical wound care was 27% in the PRE group vs 89% in the POST group (p&amp;lt; 0.01). Conclusions Adherence to a CPG for the prevention and treatment of FWC and FWI was associated with a lower (but not statistically significant) prevalence of these complications. Limitations include a difference in the TBSA between the 2 groups and potential concurrent changes in practice. Ongoing data collection includes the evaluation of other potential contributing factors. Applicability of Research to Practice Fungi are common in the environment, and when combined with immunosuppression and extensive open wounds, may cause wound infection in burn patients. More research is needed to further evaluate effective treatments for the prevention and treatment of FWC and FWI in these patients.

546 Winning the Race Against Pathogens: A Regional Burn Center Experience with a Cleansing Protocol

Abstract Introduction The skin is the first immune defense mechanism, and it functions as a barrier against various microorganisms. Burn injury will compromise this important barrier. Infections are the primary factor contributing to burn mortality, resulting in &amp;gt;50% of deaths in burn patients. In 2020, our Adult and Pediatric Burn Center instituted a pure Hypochlorous Acid (pHA) antimicrobial protocol to enhance skin barrier function. Methods We conducted a retrospective analysis on the effect of the introduction of the pHA protocol on the number of reportable infections in our Burn Center. The period of observation in this report is 2017-2021. Beginning in 2020, adults and children received topical wound care and bathing with our pHA protocol. No dilution of the product was used. The product was placed into a sterile basin and the patient was cleaned head to toe, including the genitalia and the wounds. Since invasive procedures such as placement of central venous catheters or urinary collection catheters may be a conduit of infection, the present report includes data regarding the number of patients experiencing clostridium difficile, central line-associated blood stream infection and catheter-associated urinary tract infections. Results From 2017-2021, our Burn Center admitted 2,223 patients. We computed a percent change in infections from before (2017-2019) to after (2021) the pHA protocol was implemented. We used 2021 because this was the first full year after the pHA protocol was introduced. We subtracted the total number of infections in 2021 from the average number of infections per year in 2017-2019 and divided by the average number of infections per year in 2017-2019. We found a 55% decrease in infections after the pHA protocol was introduced. There was no evidence of toxicity in adult or pediatric patients associated with care during introduction of the pHA protocol, including skin graft sites. Conclusions This analysis indicates a notable decrease in infections. The pHA procedure shows no evidence of viral, fungal or bacterial pathogens causing significant issues with the studied patient group. This analysis does not determine whether the decrease in infections is clinically or statistically significant. Applicability of Research to Practice Reducing infections in burn patients which can be life saving.

Pan-Resistance; A Rising Challenge in Burns Patients

Introduction: Burn injuries by fire and hot liquids and contact with hot surfaces have been recognized as a significant and major public health problem in economically developing countries. Objectives: The main objective of the study is to find the incidence of pan-resistant strain infections, in burns Khyber teaching hospital, Peshawar. Material and methods: A retrospective observational study was conducted to determine the incidence of pan-resistant strain infections in burn patients at Khyber Teaching Hospital, Peshawar. The study was conducted over a period of 12 months, from January 1, 2022, to December 31, 2022. Khyber Teaching Hospital is a tertiary care hospital located in Peshawar, the capital city of Khyber Pakhtunkhwa province in Pakistan. Results: Table 1 presents the demographic and clinical characteristics of the study population. The table shows that the study included 100 patients with burn injuries, with a mean age of 28.5 years (SD 14.7). The majority of patients were male (70.0%) and had burn injuries covering more than 10% of their total body surface area (78.0%). The most common cause of burn injury was flame (52.0%). The mean length of hospital stay was 15.4 days. Practical Implication: This study implies and plays a role in finding the proper antibiotics which will be used for burn wounds. Conclusion: The study concludes that a significant proportion of bacterial isolates obtained from burn wound cultures were resistant to multiple antibiotics, with Acinetobacter baumannii showing a pan-resistant pattern. Keywords: Significant, Acinetobacter, Surface, Resistance, Clinical, Wound

Anti-Pseudomonas aeruginosa Vaccines and Therapies: An Assessment of Clinical Trials.

Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen that causes high morbidity and mortality in cystic fibrosis (CF) and immunocompromised patients, including patients with ventilator-associated pneumonia (VAP), severely burned patients, and patients with surgical wounds. Due to the intrinsic and extrinsic antibiotic resistance mechanisms, the ability to produce several cell-associated and extracellular virulence factors, and the capacity to adapt to several environmental conditions, eradicating P. aeruginosa within infected patients is difficult. Pseudomonas aeruginosa is one of the six multi-drug-resistant pathogens (ESKAPE) considered by the World Health Organization (WHO) as an entire group for which the development of novel antibiotics is urgently needed. In the United States (US) and within the last several years, P. aeruginosa caused 27% of deaths and approximately USD 767 million annually in health-care costs. Several P. aeruginosa therapies, including new antimicrobial agents, derivatives of existing antibiotics, novel antimicrobial agents such as bacteriophages and their chelators, potential vaccines targeting specific virulence factors, and immunotherapies have been developed. Within the last 2-3 decades, the efficacy of these different treatments was tested in clinical and preclinical trials. Despite these trials, no P. aeruginosa treatment is currently approved or available. In this review, we examined several of these clinicals, specifically those designed to combat P. aeruginosa infections in CF patients, patients with P. aeruginosa VAP, and P. aeruginosa-infected burn patients.