Clostridium difficile infections in patients with severe burns

Scott J. Crabtree, Janelle L. Robertson, Kevin K. Chung, Evan M. Renz, Steven Wolf, Duane R. Hospenthal, Clinton K. Murray

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

With improved survival in burn patients, Clostridium difficile infection (CDI) remains a significant potential complication. The incidence of, risk factors for, and outcomes of CDI in severely burned patients are poorly studied and remain unclear. This study involves retrospective case control and cohort studies using electronic medical records from February 1, 2002 to January 31, 2009 at the US Department of Defense's only burn unit. Demographic, risk factor, and outcome data were collected for all C. difficile toxin positive patients in the burn, medical, and surgical intensive care units and the hospital's step down unit along with an additional analysis of a 2:1 matched control of C. difficile toxin negative to positive burn patients. In the burn intensive care unit (BICU) population there was an incidence of 7.9 cases per 10,000 patient days; less than the non-burn unit rate of 15.2 cases (p-value < 0.01). The BICU patients were young males with a median 42% total body surface area burns. There were higher frequencies of operations and prior aminoglycoside use, with longer unit stays and times until death or discharge. There was no difference in treatments, morbidity, or mortality. The comparison of patients with positive and negative C. difficile toxin among those in the BICU revealed few significant differences in risk factors or outcomes. Differences in risk factors between burn and non-burn patients were likely markers of the populations rather than independent risk factors for CDI in the burn population with overall lower rates likely reflective of younger, healthier patients in the BICU and more aggressive infection control practices.

Original languageEnglish (US)
Pages (from-to)42-48
Number of pages7
JournalBurns
Volume37
Issue number1
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Fingerprint

Clostridium Infections
Clostridium difficile
Burns
Intensive Care Units
United States Department of Defense
Population
Burn Units
Electronic Health Records
Body Surface Area
Incidence
Aminoglycosides
Critical Care
Infection Control
Case-Control Studies
Cohort Studies
Retrospective Studies
Demography
Morbidity

Keywords

  • Burn
  • Clostridial
  • Clostridium difficile
  • Colitis
  • Diarrhea

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Crabtree, S. J., Robertson, J. L., Chung, K. K., Renz, E. M., Wolf, S., Hospenthal, D. R., & Murray, C. K. (2011). Clostridium difficile infections in patients with severe burns. Burns, 37(1), 42-48. https://doi.org/10.1016/j.burns.2010.06.008

Clostridium difficile infections in patients with severe burns. / Crabtree, Scott J.; Robertson, Janelle L.; Chung, Kevin K.; Renz, Evan M.; Wolf, Steven; Hospenthal, Duane R.; Murray, Clinton K.

In: Burns, Vol. 37, No. 1, 01.02.2011, p. 42-48.

Research output: Contribution to journalArticle

Crabtree, SJ, Robertson, JL, Chung, KK, Renz, EM, Wolf, S, Hospenthal, DR & Murray, CK 2011, 'Clostridium difficile infections in patients with severe burns', Burns, vol. 37, no. 1, pp. 42-48. https://doi.org/10.1016/j.burns.2010.06.008
Crabtree SJ, Robertson JL, Chung KK, Renz EM, Wolf S, Hospenthal DR et al. Clostridium difficile infections in patients with severe burns. Burns. 2011 Feb 1;37(1):42-48. https://doi.org/10.1016/j.burns.2010.06.008
Crabtree, Scott J. ; Robertson, Janelle L. ; Chung, Kevin K. ; Renz, Evan M. ; Wolf, Steven ; Hospenthal, Duane R. ; Murray, Clinton K. / Clostridium difficile infections in patients with severe burns. In: Burns. 2011 ; Vol. 37, No. 1. pp. 42-48.
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