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Staphylococcus aureus carriage at admission predicts early-onset pneumonia after burn trauma.
Journal article

Staphylococcus aureus carriage at admission predicts early-onset pneumonia after burn trauma.

  • Fournier A Pharmacy Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Voirol P Pharmacy Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Krähenbühl M Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Bonnemain CL Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Fournier C Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Dupuis-Lozeron E Unit of Population Epidemiology, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
  • Pantet O Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Pagani JL Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Revelly JP Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Sadeghipour F Pharmacy Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Eggimann P Adult Intensive Medicine Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Que YA Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010, Bern, Switzerland. yok-ai.que@insel.ch.
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  • 2016-11-06
Published in:
  • European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. - 2017
Adult
Burns
Carrier State
Female
Humans
Male
Middle Aged
Pneumonia, Staphylococcal
Respiration, Artificial
Retrospective Studies
Risk Assessment
Staphylococcus aureus
Wounds and Injuries
English Early-onset pneumonia (EOP) is frequent after burn trauma, increasing morbidity in the critical resuscitation phase, which may preclude early aggressive management of burn wounds. Currently, however, preemptive treatment is not recommended. The aim of this study was to identify predictive factors for EOP that may justify early empirical antibiotic treatment. Data for all burn patients requiring ≥4 h mechanical ventilation (MV) who were admitted between January 2001 and October 2012 were extracted from the hospital's computerized information system. We reviewed EOP episodes (≤7 days) among patients who underwent endotracheal aspiration (ETA) within 5 days after admission. Univariate and multivariate analyses were performed to identify independent factors associated with EOP. Logistic regression was used to identify factors predicting EOP development. During the study period, 396 burn patients were admitted. ETA was performed within 5 days in 204/290 patients receiving ≥4 h MV. One hundred and eight patients developed EOP; 47 cases were caused by Staphylococcus aureus, 37 by Haemophilus influenzae, and 23 by Streptococcus pneumoniae. Among the 33 patients showing S. aureus positivity on ETA samples, 16 (48.5 %) developed S. aureus EOP. Among the 156 S. aureus non-carriers, 16 (10.2 %) developed EOP. Staphylococcus aureus carriage independently predicted EOP (p < 0.0001). We identified S. aureus carriage as an independent and strong predictor of EOP. As rapid point-of-care testing for S. aureus is readily available, we recommend testing of all patients at admission for burn trauma and the consideration of early preemptive treatment in all positive patients. Further studies are needed to evaluate this new strategy.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/278633
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