Demographic and clinical factors associated with hospital infections in burned children and adolescents

Abstract

Background and Objectives: burns are a leading cause of domestic accidents and the third leading cause of mortality in children and adolescents under 14 years old. This study aimed to identify demographic and clinical factors associated with healthcare-associated infections (HAIs) in burn victims under 18 years old treated at a Burn Treatment Center (BTC).Methods: this cross-sectional analytical study was conducted at the BTC of a public hospital using HAI notification records and medical records of patients under 18 years hospitalized from 2009 to 2019. The demographic variables considered were sex and age, while the clinical variables included causal agent, total body surface area (TBSA), burn depth, duration and location of hospitalization, dates of admission and infection detection, diagnosis of HAIs, invasive and surgical procedures, site of infection, etiological agent, antimicrobial susceptibility profile, antimicrobial agents used in the treatment of infections, diagnosis of sepsis and septic shock as well as the clinical outcome. Absolute and relative frequencies were used, and the chi-square test was applied for categorical variables. Multivariate analysis was conducted using Poisson regression with robust variance adjustment. Results: among the 591 victims, 187 (31.6%) developed HAIs. HAIs were associated with larger TBSA, third-degree burns, longer hospitalization, and mortality. Factors associated with HAIs included burn area ≥21%, hospitalization ≥15 days, and mortality. The prevalent microorganisms were multidrug-resistant (MDR) Acinetobacter baumannii and MDR Pseudomonas aeruginosa. Conclusion: children with severe burns and prolonged hospitalization were more vulnerable to HAIs and associated mortality.