Infect Chemother.  2005 Oct;37(5):265-270.

Clinical Characteristics and Risk Factors of Mortality among Severe Burn Patients with Isolation of Vancomycin-Resistant Enterococci

• Byun HW
• Kim CH
• Kim JK
• Son KP
• Han SY
• Kim YS
• Woo H
• Hyun IG
• Kim JH
• Lee KM

Abstract

BACKGROUND: Vancomycin-resistant enterococci (VRE) are multi-drug resistant organisms that have emerged as important nosocomial pathogens in recent years. Patients with burn injury are highly vulnerable to VRE infection. We evaluated the colonization and infection rate of VRE among severe burn patients.
MATERIALS AND METHODS
We retrospectively reviewed VRE isolation in a tertiary hospital burn center from January 2000 to December 2003. We analyzed and compared the clinical characteristics of VRE colonized (isolated in rectal swab) and infected patients. We also analyzed the risk factors of mortality in VRE infection group by using univariate and multivariate analyses.
RESULTS
VRE was isolated from 104 of severe burn patients. Mean percent of total body surface area of 104 patients was 45.43+/-22.15%. The most commonly isolated VRE was Enterococcus faecium (82.6%). The VRE infection rate of VRE colonization group was 19/93 (20.4%). There were no differences in clinical characteristics, underlying conditions, and isolates species between VRE colonization and infection groups. The mortality rate of VRE infection group was 40%. The risk factors for mortality were bacteremia (P=0.001) and mechanical ventilation (P=0.024) in univariate analysis. However, independent risk factor for death was only VRE bacteremia [odd ratio=32.803, 95% confidence interval (2.884, 373.129), P=0.005] in multivariate analysis.
CONCLUSION
Significant portion of severe burn patients with VRE colonization could progress to VRE infection. Severe burn patients with VRE bacteremia have higher risk of death than patients without VRE bacteremia.

Keyword

Burn; Vancomycin resistance; Enterococcus; Mortality

MeSH Terms

Bacteremia
Body Surface Area
Burn Units
Burns*
Colon
Enterococcus
Enterococcus faecium
Humans
Mortality*
Multivariate Analysis
Respiration, Artificial
Retrospective Studies
Risk Factors*
Tertiary Care Centers
Vancomycin Resistance