Hospital-acquired sepsis in burn patients: epidemiology, bacterial profiles, and risk factors in a tertiary burn center in Iran

Sepsis is a significant cause of morbidity and mortality in burn patients due to compromised skin integrity and immune dysfunction. Despite advancements in burn care, hospital-acquired infections continue to be a significant challenge, particularly in low-resource settings. This cross-sectional observational study was conducted over a ۱۲-month period at Mousavi Hospital, a tertiary referral burn center in Zanjan, Iran. All patients admitted with burn injuries who remained hospitalized for more than ۷۲ hours were evaluated for hospital-acquired sepsis. Sepsis was diagnosed based on the combination of clinical signs and relevant laboratory and imaging findings. Demographic, clinical, and microbiological data were collected from medical records. Multivariate logistic regression was used to identify independent risk factors. Among ۴۵۳ burn patients, ۱۷۶ (۳۸.۸%) developed hospital-acquired sepsis. Sepsis was significantly associated with advanced age (p = ۰.۰۰۷), rural residence (p < ۰.۰۰۱), lower educational level (p = ۰.۰۰۴), higher burn severity (p < ۰.۰۰۱), and prolonged hospitalization (p < ۰.۰۰۱). The most commonly isolated microorganism was Pseudomonas aeruginosa (۳۲.۱%), followed by Citrobacter spp. (۲۲.۶%) and Staphylococcus aureus (۱۵.۱%). Multivariate logistic regression identified burn percentage (OR = ۱.۱۸۴, p = ۰.۰۰۱), length of hospital stay (OR = ۱.۵۸۵, p < ۰.۰۰۱), and lower educational level (OR = ۰.۵۰۱, p = ۰.۰۰۵) as independent predictors of sepsis. Hospital-acquired sepsis remains highly prevalent in burn patients. The key independent predictors were Total Body Surface Area (TBSA), duration of hospitalization, and education level. Regular microbial surveillance, timely diagnosis using burn-specific criteria, and targeted infection control measures are essential to reducing sepsis-related complications in this vulnerable population.Sepsis is a significant cause of morbidity and mortality in burn patients due to compromised skin integrity and immune dysfunction. Despite advancements in burn care, hospital-acquired infections continue to be a significant challenge, particularly in low-resource settings. This cross-sectional observational study was conducted over a ۱۲-month period at Mousavi Hospital, a tertiary referral burn center in Zanjan, Iran. All patients admitted with burn injuries who remained hospitalized for more than ۷۲ hours were evaluated for hospital-acquired sepsis. Sepsis was diagnosed based on the combination of clinical signs and relevant laboratory and imaging findings. Demographic, clinical, and microbiological data were collected from medical records. Multivariate logistic regression was used to identify independent risk factors. Among ۴۵۳ burn patients, ۱۷۶ (۳۸.۸%) developed hospital-acquired sepsis. Sepsis was significantly associated with advanced age (p = ۰.۰۰۷), rural residence (p < ۰.۰۰۱), lower educational level (p = ۰.۰۰۴), higher burn severity (p < ۰.۰۰۱), and prolonged hospitalization (p < ۰.۰۰۱). The most commonly isolated microorganism was Pseudomonas aeruginosa (۳۲.۱%), followed by Citrobacter spp. (۲۲.۶%) and Staphylococcus aureus (۱۵.۱%). Multivariate logistic regression identified burn percentage (OR = ۱.۱۸۴, p = ۰.۰۰۱), length of hospital stay (OR = ۱.۵۸۵, p < ۰.۰۰۱), and lower educational level (OR = ۰.۵۰۱, p = ۰.۰۰۵) as independent predictors of sepsis. Hospital-acquired sepsis remains highly prevalent in burn patients. The key independent predictors were Total Body Surface Area (TBSA), duration of hospitalization, and education level. Regular microbial surveillance, timely diagnosis using burn-specific criteria, and targeted infection control measures are essential to reducing sepsis-related complications in this vulnerable population.

کلیدواژه ها:

Burns ، Sepsis ، Risk factors ، Infection ، Complication