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Clinical Characteristics and Risk Factors of Mortality among Severe Burn Patients with Isolation of Vancomycin-Resistant Enterococci

감염과화학요법 2005년 37권 5호 p.265 ~ 270
변현우, 김철홍, 김진경, 손광표, 한승용, 김영순, 우흥정, 현인규, 김종현, 이규만,
소속 상세정보
변현우 ( Byun Hyeon-Woo ) - 한림대학교 의과대학 내과학교실
김철홍 ( Kim Cheol-Hong ) - 한림대학교 의과대학 내과학교실
김진경 ( Kim Jin-Kyung ) - 한림대학교 의과대학 내과학교실
손광표 ( Son Kwang-Pyo ) - 한림대학교 의과대학 내과학교실
한승용 ( Han Seung-Yong ) - 한림대학교 의과대학 내과학교실
김영순 ( Kim Young-Soon ) - 한림대학교 의과대학 내과학교실
우흥정 ( Woo Heung-Jeong ) - 한림대학교 의과대학 내과학교실
현인규 ( Hyun In-Gyu ) - 한림대학교 의과대학 내과학교실
김종현 ( Kim Jong-Hyun ) - 한림대학교 의과대학 외과학교실
이규만 ( Lee Kyu-Man ) - 한림대학교 의과대학 진단검사의학교실

Abstract


Background: Vancomycin-resistant enterococci (VRE) are multi-drug resistant organisms that have emerged as important nosocomial pathogens in recent years. Patients with burn injury are highly vulnerable to VRE infection. We evaluated the colonization and infection rate of VRE among severe burn patients.

Materials & Methods: We retrospectively reviewed VRE isolation in a tertiary hospital burn center from January 2000 to December 2003. We analyzed and compared the clinical characteristics of VRE colonized (isolated in rectal swab) and infected patients. We also analyzed the risk factors of mortality in VRE infection group by using univariate and multivariate analyses.

Results: VRE was isolated from 104 of severe burn patients. Mean percent of total body surface area of 104 patients was 45.43+/-22.15%. The most commonly isolated VRE was Enterococcus faecium (82.6%). The VRE infection rate of VRE colonization group was 19/93 (20.4%). There were no differences in clinical characteristics, underlying conditions, and isolates species between VRE colonization and infection groups. The mortality rate of VRE infection group was 40%. The risk factors for mortality were bacteremia (P=0.001) and mechanical ventilation (P=0.024) in univariate analysis. However, independent risk factor for death was only VRE bacteremia [odd ratio=32.803, 95% confidence interval (2.884, 373.129), P=0.005] in multivariate analysis.

Conclusion: Significant portion of severe burn patients with VRE colonization could progress to VRE infection. Severe burn patients with VRE bacteremia have higher risk of death than patients without VRE bacteremia.

키워드

Burn;Vancomycin Resistant;Enterococcus;Mortality

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