The frequency of nosocomial infection and environmental contamination in the burn center
DOI:
https://doi.org/10.61186/jcbior.5.2.281Keywords:
Bacterial infections, Nosocomial infection, Burns patient, Bacterial contaminationAbstract
Nosocomial infections result in a high rate of morbidity and mortality globally. The present study investigated patterns of bacterial contamination in the hospital environment and hospital-acquired infections in hospitalized burn patients.This cross-sectional study was conducted on 212 hospital environmental samples and 673 clinical samples of hospitalized burn patients in Velayat Hospital, Rasht, Iran, from 2018 to 2021. Demographical data and clinical characteristics of burn patients were recorded and analyzed. The data of reported infections were recorded to find the infection pattern. All data was performed using SPSS version 22, and the significant level was set at 0.05. Among 212 environmental samples, 94.8% were from hospital surfaces, with the ICU being the most sampled area (36.8%). Fungal infections were most prevalent (65.5%), followed by Staphylococcus spp. (19.8%). Analysis of 673 burn patients showed a predominantly male population (74.5%), with a mean age of 39.50 years and an average burn severity of 39.57%. Patients typically developed infections 3.91 days post-admission, with an average hospital stay of 12.07 days. The mortality rate was high at 50.3%. Pseudomonas aeruginosa (P. aeruginosa) was the most common pathogen in patients (34.9%), followed by Klebsiella spp. (12.3%), with 46.9% of isolates remaining unidentified. The study illustrated the urgent need for improved infection control strategies, enhanced environmental monitoring, and better diagnostic capabilities to reduce the high rates of nosocomial infections and improve patient outcomes in burn centers.
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1. Abban MK, Ayerakwa EA, Mosi L, Isawumi A. The burden of hospital acquired infections and antimicrobial resistance. Heliyon. 2023;9(10):e20561. DOI: 10.1016/j.heliyon.2023.e20561
2. Fortunka K, Strzelecka A, Król G, Paprocka P, Mańkowska A, Lesiak A, Karpeta U, Okła S, Spałek J, Kaliniak S, Piktel E. Knowledge and Training Needs in Nosocomial Infection among Hospital Staff in the City of Kielce, Poland: A Cross‐Sectional Study. Journal of Nursing Management. 2024;2024(1):9243232. DOI: 10.1155/2024/9243232
3. Hosseini M, Hasannejad-Bibalan M, Yaghoubi T, Mobayen M, Khoshdoz P, Khoshdoz S, et al. Prevalence and Antibiotic Resistance Pattern of Gram-Positive Isolates from Burn Patients in Velayat Burn Center in Rasht, North of Iran. Med Lab J. 2021;15(6):52–7. DOI: 10.61186/mlj.15.6.52
4. Maitz J, Merlino J, Rizzo S, McKew G, Maitz P. Burn wound infections microbiome and novel approaches using therapeutic microorganisms in burn wound infection control. Adv Drug Deliv Rev. 2023;196:114769. DOI: 10.1016/j.addr.2023.114769
5. Voidazan S, Albu S, Toth R, Grigorescu B, Rachita A, Moldovan I. Healthcare associated infections—a new pathology in medical practice? Int J Environ Res Public Health. 2020;17(3):760. DOI: 10.3390/ijerph17030760
6. Olise CC, Simon-Oke IA, et al. Fomites: Possible vehicle of nosocomial infections. J pub health catalog. 2018;1(1):16-16 DOI: 10.35841/public-health-nutrition.1.1.11-16
7. Ghashghaee A, Benis MR, Aryankhesal A, Tanha K, Hosseinifard H, Janani L, et al. The Prevalence of Hospital-Acquired Infections in the EMRO: A Systematic Review and Meta-Analysis from 2000 to 2018. 2019. DOI: 10.2139/ssrn.3339500
8. Roberts RR, Scott RD 2nd, Hota B, Kampe LM, Abbasi F, Schabowski S, Ahmad I, Ciavarella GG, Cordell R, Solomon SL, Hagtvedt R, Weinstein RA. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods. Med Care. 2010;48(11):1026-35. DOI: 10.1097/MLR.0b013e3181ef60a2 PMID: 20940650
9. Raoofi S, Pashazadeh Kan F, Rafiei S, Hosseinipalangi Z, Noorani Mejareh Z, Khani S, et al. Global prevalence of nosocomial infection: A systematic review and meta-analysis. PLoS One. 2023;18(1):e0274248. DOI: 10.1371/journal.pone.0274248 PMID: 36706112
10. Escandón-Vargas K, Tangua AR, Medina P, Zorrilla-Vaca A, Briceño E, Clavijo-Martínez T, Tróchez JP. Healthcare-associated infections in burn patients: timeline and risk factors. Burns. 2020;46(8):1775-86. DOI: 10.1016/j.burns.2020.04.031
11. Leseva M, Arguirova M, Nashev D, Zamfirova E, Hadzhyiski O. Nosocomial infections in burn patients: etiology, antimicrobial resistance, means to control. Ann Burns Fire Disasters. 2013;26(1):5–11. PMID: 23966892
12. Lowe H, Woodd S, Lange IL, Janjanin S, Barnet J, Graham W. Challenges and opportunities for infection prevention and control in hospitals in conflict-affected settings: a qualitative study. Confl Health. 2021;15(1):94. DOI: 10.1186/s13031-021-00428-8
13. Khadem-Rezaiyan M, Aghajani H, Ahmadabadi A, Zanganeh M, Tavousi SH, Sedaghat A, et al. Epidemiology of severe burns in North-East of Iran: How is the burn size different in a developing country from developed ones? Burn Open. 2020;4(1):4–9. DOI: 10.1016/j.burnso.2019.11.005
14. Nadi ZB, Raisali F, Jafari N, Bayramzadeh S. The influence of physical environment on health care–associated infections: A literature review. Am J Infect Control. 2024;52(2):229–42. DOI: 10.1016/j.ajic.2023.06.010
15. Yang Y, Zeng Q, Hu G, Wang Z, Chen Z, Zhou L, et al. Distribution of Nosocomial Pathogens and Antimicrobial Resistance among Patients with Burn Injuries in China: A Comprehensive Research Synopsis and Meta-Analysis. Infect Dis Ther. 2024;13(6):1291–313. DOI: 10.1007/s40121-024-00983-6
16. Faraji N, Malekzadegan Y, Khashei R, Haghighi MA, Alam AN, Fathi J, Ebrahim-Saraie HS. The prevalence and characterization of the epidemic ST239-MRSA clone. Reviews and Research in Medical Microbiology. 2024;35(1):1-7. DOI: 10.1097/MRM.0000000000000317
17. Wang Y, Wong FKY, Bayuo J, Chung LYF, Zhang L, Wang T. Challenges of nurses and family members of burn patients: Integrative review. Nurs open. 2023;10(6):3547–60. DOI: 10.1002/nop2.1651
18. Datta PK, Roy Chowdhury S, Aravindan A, Saha S, Rapaka S. Medical and Surgical Care of Critical Burn Patients: A Comprehensive Review of Current Evidence and Practice. Cureus. 2022;14(11):e31550. DOI: 10.7759/cureus.31550 PMID: 36540501
19. Abbas S. The challenges of implementing infection prevention and antimicrobial stewardship programs in resource-constrained settings. Antimicrob Steward Healthc Epidemiol. 2024;16;4(1):e45. DOI: 10.1017/ash.2024.35 PMID: 38628374
20. Roy S, Mukherjee P, Kundu S, Majumder D, Raychaudhuri V, Choudhury L. Microbial infections in burn patients. Acute Crit Care. 2024;39(2):214-225. DOI: 10.4266/acc.2023.01571 PMID: 38863352
21. Suleyman G, Alangaden G, Bardossy AC. The Role of Environmental Contamination in the Transmission of Nosocomial Pathogens and Healthcare-Associated Infections. Curr Infect Dis Rep. 2018;20(6):12. DOI: 10.1007/s11908-018-0620-2
22. Nimer NA. Nosocomial Infection and Antibiotic-Resistant Threat in the Middle East. Infect Drug Resist. 2022;15:631-639. DOI: 10.2147/IDR.S351755 PMID: 35241915
23. Vinaik R, Barayan D, Shahrokhi S, Jeschke MG. Management and prevention of drug resistant infections in burn patients. Expert Rev Anti Infect Ther. 2019;17(8):607-619. DOI: 10.1080/14787210.2019.1648208 PMID: 31353976
24. Weber DJ, Anderson D, Rutala WA. The role of the surface environment in healthcare-associated infections. Curr Opin Infect Dis. 2013;26(4):338-44. DOI: 10.1097/QCO.0b013e3283630f04. PMID: 23743816
25. Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, et al. Prevalence and Outcomes of Infection Among Patients in Intensive Care Units in 2017. JAMA. 2020;323(15):1478–87. DOI: 10.1001/jama.2020.2717 PMID: 32207816
26. Jeschke MG, van Baar ME, Choudhry MA, Chung KK, Gibran NS, Logsetty S. Burn injury. Nat Rev Dis Primers. 2020;6(1):11. DOI: 10.1038/s41572-020-0145-5. PMID: 32054846
27. Blot S, Ruppé E, Harbarth S, Asehnoune K, Poulakou G, Luyt CE, et al. Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive Crit care Nurs. 2022; 70:103227. DOI: 10.1016/j.iccn.2022.103227 PMID: 35249794
28. Burgess M, Valdera F, Varon D, Kankuri E, Nuutila K. The Immune and Regenerative Response to Burn Injury. Cells. 2022;11(19):3073. DOI: 10.3390/cells11193073 PMID: 36231034
29. Han Y, Zhang J, Zhang HZ, Zhang XY, Wang YM. Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors. World J Clin Cases. 2022;10(6):1795-1805. DOI: 10.12998/wjcc.v10.i6.1795 PMID: 35317164
30. Mehta K, Arega H, Smith NL, Li K, Gause E, Lee J, et al. Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study. Am J Surg. 2022;223(1):157–63. DOI: 10.1016/j.amjsurg.2021.07.041 PMID: 34330521
31. El Hamzaoui N, Barguigua A, Larouz S, Maouloua M. Epidemiology of burn wound bacterial infections at a Meknes hospital, Morocco. New Microbes New Infect. 2020;38:100764. DOI: 10.1016/j.nmni.2020.100764 PMID: 33163199
32. Zhou S, Xiao S, Wang X, Wang X, Han L. Risk Factors and Pathogens of Wound Infection in Burn Inpatients from East China. Antibiotics (Basel). 2023;12(9):1432. DOI: 10.3390/antibiotics12091432 PMID: 37760728
33. Lachiewicz AM, Hauck CG, Weber DJ, Cairns BA, van Duin D. Bacterial Infections After Burn Injuries: Impact of Multidrug Resistance. Clin Infect Dis. 201;65(12):2130–6. DOI: 10.1093/cid/cix682
34. Cabral L, Afreixo V, Santos F, Almeida L, Paiva JA. Procalcitonin for the early diagnosis of sepsis in burn patients: A retrospective study. Burns. 2017;43(7):1427-1434. DOI: 10.1016/j.burns.2017.03.026 PMID: 28454850
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