Evaluation of Healthcare-Associated Infections in Children in a Burn Center

Objective: Infections are major causes of morbidity and mortality in burn patients. The most common infections include wound infection, bloodstream infections, and sepsis. Pseudomonas aeruginosa and Staphylococcus aureus are the most common organisms. The aim of this study was to determine the epidemiological characteristics of patients, causes of burns, infections, responsible microorganisms, and treatment strategies. Methods: This was a cross-sectional study. The medical records of burn patients aged between 1 month and 18 years in 2012-2018 were retrospectively reviewed. Age, sex, length of hospital stay, severity of burns, burn type, burn site, burn percentage, applied interventions and treatments, infections, and prognosis were recorded. Infection definitions were determined according to the National Health Service Associated Infections Surveillance Guide. Microorganisms at surgical sites and in blood, urine, and tracheal aspirate samples, and antimicrobial susceptibilities were recorded. Results: In total, 878 patients were included in the study. The most common etiology was scalding (77.3%), and the most frequently injured anatomical areas were the trunk and extremities (59.1%). The prevalence of total infection was 12.6%. Forty-four of the total infections were sepsis, 23 were wound infections, 19 were urinary tract infections, and 17 were bloodstream infections. P. aeruginosa was detected in 5 patients, Escherichia coli in 17, Klebsiella pneumonia in 3, S. aureus in 8, Enterococcus spp. in 6, and coagulase-negative staphylococci in 20. Presence of catheter and percentage of burn surface area were significantly higher and the duration of hospitalization was significantly longer in patients with infection. Conclusion: At pediatric burn centers, the identification of infectious agents, development appropriate antibiotic strategies, avoidance of the use of prophylactic antibiotics, and strict adherence to isolation measures will reduce the risk of infection.