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

Détails

ID Serval
serval:BIB_3570AFA2FB29
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Staphylococcus aureus carriage at admission predicts early-onset pneumonia after burn trauma.
Périodique
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
Auteur(s)
Fournier A., Voirol P., Krähenbühl M., Bonnemain C.L., Fournier C., Dupuis-Lozeron E., Pantet O., Pagani J.L., Revelly J.P., Sadeghipour F., Eggimann P., Que Y.A.
ISSN
1435-4373 (Electronic)
ISSN-L
0934-9723
Statut éditorial
Publié
Date de publication
04/2017
Peer-reviewed
Oui
Volume
36
Numéro
3
Pages
523-528
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.

Mots-clé
Adult, Burns/complications, Carrier State/microbiology, Female, Humans, Male, Middle Aged, Pneumonia, Staphylococcal/epidemiology, Pneumonia, Staphylococcal/microbiology, Pneumonia, Staphylococcal/therapy, Respiration, Artificial/utilization, Retrospective Studies, Risk Assessment, Staphylococcus aureus/isolation & purification, Wounds and Injuries/complications
Pubmed
Web of science
Création de la notice
30/11/2016 22:17
Dernière modification de la notice
20/08/2019 14:22
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