CÁC YẾU TỐ ẢNH HƯỞNG ĐẾN NHIỄM VI KHUẨN ĐA KHÁNG TRÊN BỆNH NHÂN BỎNG NẶNG

Abstract

Objectives: Assessment of risk factors associated with multidrug-resistant bacteria (MDRb) bacterial infections in severely burned patients. Methods: A total of 131 patients with severe burns (422 culture time points) were treated at the Intensive Care Unit of Le Huu Trac National Burn Hospital from January 2023 to December 2023. Results: Patients with MDRb infection had significantly larger burn extent, larger deep burn area, higher blood lactate levels, and higher white blood cell counts on admission, as well as a higher prevalence of deep burns involving the back, chest, abdomen, and lower extremities compared with patients without MDRb infection (p < 0.01). At the time of microbiological culture, the MDRb group had a significantly longer interval from burn injury to culture sampling, higher SOFA scores, higher neutrophil-to-lymphocyte ratios, greater volumes of plasma transfused, higher numbers of packed red blood cell units transfused, a higher proportion of patients with a pulmonary SOFA score ≥ 2, and more frequent use of vasopressors compared with the non-MDRb group (p < 0.01). Multivariable analysis showed that burn extent and the volume of plasma transfused were independently associated with MDRb infection (p < 0.05). Each 1% increase in burn extent was associated with a 3% increase in the risk of MDR bacterial infection, and each additional 1 mL of plasma transfused increased the risk by 0.04%, after adjustment for other covariates (p < 0.05). Conclusion: Total burn surface area and the volume of plasma transfused were independently associated with multidrug-resistant bacterial infection (p < 0.05).