ArticleWorld journal of surgery2018
Colonization with Multidrug-Resistant Enterobacteriaceae is Associated with Increased Mortality Following Burn Injury in Sub-Saharan Africa.
Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Review and analysis of the overlapping threats of carbapenem and polymyxin resistant E. coli and Klebsiella in Africa.Antimicrobial resistance and infection control · 2023Pooled it
- Multidrug-resistant Enterobacterales causing wound infections in Ibadan, Nigeria: Phenotypic resistance and detection ofIJID regions · 2026Article
- Challenges in Antimicrobial Treatment and Antimicrobial Stewardship in Hospital-Acquired Infections in Adult Burn Patients.European burn journal · 2026Review
- Association of biofilm formation with multidrug resistance in burn wound patients isolates ofFrontiers in medicine · 2026Article
- No improvement in mortality among critically ill patients with carbapenems as initial empirical therapy and more detection of multi-drug resistant pathogens associated with longer use: a post hoc analysis of a prospective cohort study.Microbiology spectrum · 2024Observational
- Age and Injury Size Influence the Magnitude of Fecal Dysbiosis in Adult Burn Patients.Journal of burn care & research : official publication of the American Burn Association · 2022Article
- A plastic and reconstructive surgery landscape assessment of Malawi: a scoping review of Malawian literature.European journal of medical research · 2022Article
- Colonization of Extended-spectrum β-lactamase producing Enterobacterales and meticillin-resistantInfection prevention in practice · 2022Article
- Antimicrobial susceptibility profiles of clinically important bacterial pathogens at the Kamuzu Central Hospital in Lilongwe, Malawi.Malawi medical journal : the journal of Medical Association of Malawi · 2022Article
- Vaginal colonization with antimicrobial-resistant bacteria among women in labor in central Uganda: prevalence and associated factors.Antimicrobial resistance and infection control · 2021Article
- Pathogenic Characteristics and Risk Factors for ESKAPE Pathogens Infection in Burn Patients.Infection and drug resistance · 2021Article
- High Level of Multidrug-Resistant Gram-Negative Pathogens Causing Burn Wound Infections in Hospitalized Children in Dar es Salaam, Tanzania.International journal of microbiology · 2021Article
- Access to Operative Intervention Reduces Mortality in Adult Burn Patients in a Resource-Limited Setting in Sub-Saharan Africa.World journal of surgery · 2020Article
- Mortality incidence among critically ill burn patients infected with multidrug-resistant organisms: A retrospective cohort study.Scars, burns & healingArticle
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6 authors.
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Abstract
backgroundMultidrug-resistant (MDR) bacteria are an emerging international concern in low- and middle-income countries that threaten recent public health gains. These challenges are exacerbated in immunocompromised hosts, such as those with burn injury. This study sought to describe the epidemiology and associated clinical outcomes of burn wound colonization in a Malawian tertiary burn center.
methodsThis is a prospective analysis of burn patients presenting to Kamuzu Central Hospital in Lilongwe, Malawi, within 72 h of burn injury. A swab of each patient's primary wound was collected at admission and each subsequent week. The primary exposure was burn wound colonization with MDR bacteria, particularly Enterobacteriaceae. The primary outcome was in-hospital mortality. A log binomial model estimated the association between the exposure and outcome, adjusted for confounders.
resultsNinety-nine patients were enrolled with a median age of 4 years (IQR 2-12) and a male preponderance (54%). Median total body surface area burn (TBSA) was 14% (IQR 9-25), and crude in-hospital mortality was 19%. Enterobacteriaceae were the most common MDR bacteria with 36% of patients becoming colonized. Wound colonization with MDR Enterobacteriaceae was associated with increased in-hospital mortality with a risk ratio of 1.86 (95% CI 1.38, 2.50, p < 0.001) adjusted for TBSA, burn type (scald vs. flame), sex, age, length of stay, and methicillin-resistant Staphylococcus aureus colonization.
conclusionMDR bacteria, especially Enterobacteriaceae, are common and are associated with worse burn injury outcomes. In resource-poor environments, a greater emphasis on prevention of MDR bacterial colonization, improved isolation precautions, affordable diagnostics, and antibiotic stewardship are imperative.
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