Prevalence of multidrug-resistant organisms recovered at a military burn center

Edward F. Keen, Brian J. Robinson, Duane R. Hospenthal, Wade K. Aldous, Steven E. Wolf, Kevin K. Chung, Clinton K. Murray

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Infections caused by multidrug-resistant (MDR) pathogens are associated with significant morbidity and mortality in patients with burn injuries. We performed a 6-year antibiotic susceptibility records review from January 2003 to December 2008 to assess the prevalence of MDR isolates by pathogen at the US Army Institute of Surgical Research Burn Center. During the study period Acinetobacter baumannii (780 isolates [22%]) was the most prevalent organism recovered, followed by Pseudomonas aeruginosa (703 isolates [20%]), Klebsiella pneumoniae (695 isolates [20%]), and Staphylococcus aureus (469 isolates [13%]). MDR prevalence rates among these isolates were A. baumannii 53%, methicillin-resistant S. aureus (MRSA) 34%, K. pneumoniae 17% and P. aeruginosa 15%. Two isolates, 1 A. baumannii and 1 P. aeruginosa, were identified as resistant to all 4 classes of antibiotics tested plus colistin. A. baumannii isolates recovered from patients with burns greater than 30% of total body surface area (TBSA) were more likely to be MDR (61%) with no significant difference for P. aeruginosa and K. pneumoniae. A higher proportion of MDR P. aeruginosa isolates were recovered from respiratory specimens compared to blood specimens (24% vs. 9%) while the opposite was true for MRSA (35% vs. 54%). A comparison of A. baumannii recovered during hospitalization days 1-5 and 15-30 revealed higher MDR levels as length of stay increased (48% vs. 75%) while no significant trends were observed for P. aeruginosa and K. pneumoniae. A similar pattern was observed for MDR A. baumannii levels for the facility between 2003 and 2005 and 2006-2008 (39% vs. 70%), with no significant increase in MDR P. aeruginosa and MDR K. pneumoniae. Increasing antibiotic resistance patterns of the most prevalent isolates recovered during extended hospitalization, impact of % TBSA and other clinical parameters may affect empirical antimicrobial therapy and patient management decisions during treatment.

Original languageEnglish (US)
Pages (from-to)819-825
Number of pages7
JournalBurns
Volume36
Issue number6
DOIs
StatePublished - Sep 2010

Fingerprint

Burn Units
Acinetobacter baumannii
Pseudomonas aeruginosa
Klebsiella pneumoniae
Body Surface Area
Methicillin-Resistant Staphylococcus aureus
Hospitalization
Anti-Bacterial Agents
Colistin
Microbial Drug Resistance
Burns
Staphylococcus aureus
Length of Stay
Morbidity
Mortality
Wounds and Injuries
Therapeutics
Infection

Keywords

  • Acinetobacter
  • Antibiotic resistance
  • Burn
  • Infection
  • Klebsiella
  • Pseudomonas
  • Staphylococcus

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Keen, E. F., Robinson, B. J., Hospenthal, D. R., Aldous, W. K., Wolf, S. E., Chung, K. K., & Murray, C. K. (2010). Prevalence of multidrug-resistant organisms recovered at a military burn center. Burns, 36(6), 819-825. https://doi.org/10.1016/j.burns.2009.10.013

Prevalence of multidrug-resistant organisms recovered at a military burn center. / Keen, Edward F.; Robinson, Brian J.; Hospenthal, Duane R.; Aldous, Wade K.; Wolf, Steven E.; Chung, Kevin K.; Murray, Clinton K.

In: Burns, Vol. 36, No. 6, 09.2010, p. 819-825.

Research output: Contribution to journalArticle

Keen, EF, Robinson, BJ, Hospenthal, DR, Aldous, WK, Wolf, SE, Chung, KK & Murray, CK 2010, 'Prevalence of multidrug-resistant organisms recovered at a military burn center', Burns, vol. 36, no. 6, pp. 819-825. https://doi.org/10.1016/j.burns.2009.10.013
Keen EF, Robinson BJ, Hospenthal DR, Aldous WK, Wolf SE, Chung KK et al. Prevalence of multidrug-resistant organisms recovered at a military burn center. Burns. 2010 Sep;36(6):819-825. https://doi.org/10.1016/j.burns.2009.10.013
Keen, Edward F. ; Robinson, Brian J. ; Hospenthal, Duane R. ; Aldous, Wade K. ; Wolf, Steven E. ; Chung, Kevin K. ; Murray, Clinton K. / Prevalence of multidrug-resistant organisms recovered at a military burn center. In: Burns. 2010 ; Vol. 36, No. 6. pp. 819-825.
@article{c6371f6b2d3e4314905e1b4ffa7f03ac,
title = "Prevalence of multidrug-resistant organisms recovered at a military burn center",
abstract = "Infections caused by multidrug-resistant (MDR) pathogens are associated with significant morbidity and mortality in patients with burn injuries. We performed a 6-year antibiotic susceptibility records review from January 2003 to December 2008 to assess the prevalence of MDR isolates by pathogen at the US Army Institute of Surgical Research Burn Center. During the study period Acinetobacter baumannii (780 isolates [22{\%}]) was the most prevalent organism recovered, followed by Pseudomonas aeruginosa (703 isolates [20{\%}]), Klebsiella pneumoniae (695 isolates [20{\%}]), and Staphylococcus aureus (469 isolates [13{\%}]). MDR prevalence rates among these isolates were A. baumannii 53{\%}, methicillin-resistant S. aureus (MRSA) 34{\%}, K. pneumoniae 17{\%} and P. aeruginosa 15{\%}. Two isolates, 1 A. baumannii and 1 P. aeruginosa, were identified as resistant to all 4 classes of antibiotics tested plus colistin. A. baumannii isolates recovered from patients with burns greater than 30{\%} of total body surface area (TBSA) were more likely to be MDR (61{\%}) with no significant difference for P. aeruginosa and K. pneumoniae. A higher proportion of MDR P. aeruginosa isolates were recovered from respiratory specimens compared to blood specimens (24{\%} vs. 9{\%}) while the opposite was true for MRSA (35{\%} vs. 54{\%}). A comparison of A. baumannii recovered during hospitalization days 1-5 and 15-30 revealed higher MDR levels as length of stay increased (48{\%} vs. 75{\%}) while no significant trends were observed for P. aeruginosa and K. pneumoniae. A similar pattern was observed for MDR A. baumannii levels for the facility between 2003 and 2005 and 2006-2008 (39{\%} vs. 70{\%}), with no significant increase in MDR P. aeruginosa and MDR K. pneumoniae. Increasing antibiotic resistance patterns of the most prevalent isolates recovered during extended hospitalization, impact of {\%} TBSA and other clinical parameters may affect empirical antimicrobial therapy and patient management decisions during treatment.",
keywords = "Acinetobacter, Antibiotic resistance, Burn, Infection, Klebsiella, Pseudomonas, Staphylococcus",
author = "Keen, {Edward F.} and Robinson, {Brian J.} and Hospenthal, {Duane R.} and Aldous, {Wade K.} and Wolf, {Steven E.} and Chung, {Kevin K.} and Murray, {Clinton K.}",
year = "2010",
month = "9",
doi = "10.1016/j.burns.2009.10.013",
language = "English (US)",
volume = "36",
pages = "819--825",
journal = "Burns",
issn = "0305-4179",
publisher = "Elsevier Limited",
number = "6",

}

TY - JOUR

T1 - Prevalence of multidrug-resistant organisms recovered at a military burn center

AU - Keen, Edward F.

AU - Robinson, Brian J.

AU - Hospenthal, Duane R.

AU - Aldous, Wade K.

AU - Wolf, Steven E.

AU - Chung, Kevin K.

AU - Murray, Clinton K.

PY - 2010/9

Y1 - 2010/9

N2 - Infections caused by multidrug-resistant (MDR) pathogens are associated with significant morbidity and mortality in patients with burn injuries. We performed a 6-year antibiotic susceptibility records review from January 2003 to December 2008 to assess the prevalence of MDR isolates by pathogen at the US Army Institute of Surgical Research Burn Center. During the study period Acinetobacter baumannii (780 isolates [22%]) was the most prevalent organism recovered, followed by Pseudomonas aeruginosa (703 isolates [20%]), Klebsiella pneumoniae (695 isolates [20%]), and Staphylococcus aureus (469 isolates [13%]). MDR prevalence rates among these isolates were A. baumannii 53%, methicillin-resistant S. aureus (MRSA) 34%, K. pneumoniae 17% and P. aeruginosa 15%. Two isolates, 1 A. baumannii and 1 P. aeruginosa, were identified as resistant to all 4 classes of antibiotics tested plus colistin. A. baumannii isolates recovered from patients with burns greater than 30% of total body surface area (TBSA) were more likely to be MDR (61%) with no significant difference for P. aeruginosa and K. pneumoniae. A higher proportion of MDR P. aeruginosa isolates were recovered from respiratory specimens compared to blood specimens (24% vs. 9%) while the opposite was true for MRSA (35% vs. 54%). A comparison of A. baumannii recovered during hospitalization days 1-5 and 15-30 revealed higher MDR levels as length of stay increased (48% vs. 75%) while no significant trends were observed for P. aeruginosa and K. pneumoniae. A similar pattern was observed for MDR A. baumannii levels for the facility between 2003 and 2005 and 2006-2008 (39% vs. 70%), with no significant increase in MDR P. aeruginosa and MDR K. pneumoniae. Increasing antibiotic resistance patterns of the most prevalent isolates recovered during extended hospitalization, impact of % TBSA and other clinical parameters may affect empirical antimicrobial therapy and patient management decisions during treatment.

AB - Infections caused by multidrug-resistant (MDR) pathogens are associated with significant morbidity and mortality in patients with burn injuries. We performed a 6-year antibiotic susceptibility records review from January 2003 to December 2008 to assess the prevalence of MDR isolates by pathogen at the US Army Institute of Surgical Research Burn Center. During the study period Acinetobacter baumannii (780 isolates [22%]) was the most prevalent organism recovered, followed by Pseudomonas aeruginosa (703 isolates [20%]), Klebsiella pneumoniae (695 isolates [20%]), and Staphylococcus aureus (469 isolates [13%]). MDR prevalence rates among these isolates were A. baumannii 53%, methicillin-resistant S. aureus (MRSA) 34%, K. pneumoniae 17% and P. aeruginosa 15%. Two isolates, 1 A. baumannii and 1 P. aeruginosa, were identified as resistant to all 4 classes of antibiotics tested plus colistin. A. baumannii isolates recovered from patients with burns greater than 30% of total body surface area (TBSA) were more likely to be MDR (61%) with no significant difference for P. aeruginosa and K. pneumoniae. A higher proportion of MDR P. aeruginosa isolates were recovered from respiratory specimens compared to blood specimens (24% vs. 9%) while the opposite was true for MRSA (35% vs. 54%). A comparison of A. baumannii recovered during hospitalization days 1-5 and 15-30 revealed higher MDR levels as length of stay increased (48% vs. 75%) while no significant trends were observed for P. aeruginosa and K. pneumoniae. A similar pattern was observed for MDR A. baumannii levels for the facility between 2003 and 2005 and 2006-2008 (39% vs. 70%), with no significant increase in MDR P. aeruginosa and MDR K. pneumoniae. Increasing antibiotic resistance patterns of the most prevalent isolates recovered during extended hospitalization, impact of % TBSA and other clinical parameters may affect empirical antimicrobial therapy and patient management decisions during treatment.

KW - Acinetobacter

KW - Antibiotic resistance

KW - Burn

KW - Infection

KW - Klebsiella

KW - Pseudomonas

KW - Staphylococcus

UR - http://www.scopus.com/inward/record.url?scp=77955578548&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955578548&partnerID=8YFLogxK

U2 - 10.1016/j.burns.2009.10.013

DO - 10.1016/j.burns.2009.10.013

M3 - Article

C2 - 20080354

AN - SCOPUS:77955578548

VL - 36

SP - 819

EP - 825

JO - Burns

JF - Burns

SN - 0305-4179

IS - 6

ER -