Use of colistin in treating multi-resistant Gram-negative organisms in a specialised burns unit

H. Ganapathy, S. K. Pal, L. Teare, Peter Dziewulski

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Patients with burns are at an increased risk of infection which can affect their outcome-duration of hospital stay, intensive care requirements, organ support, inotrope requirements, renal replacement therapy, ventilatory requirements and overall mortality. Our study aimed to evaluate the use of colistin in our burns intensive care unit (ICU) in treating multi-resistant Gram-negative infections. This was a retrospective study carried out in a regional referral centre for burns and plastics, Chelmsford, UK. We looked at data from patients admitted to our intensive care over a two-year period from November 2003 to November 2005. All patients who received colistin were included in the study. Admission data included demographic data and burn data, other relevant medical history, and blood results. We also recorded: length of ICU stay, ultimate outcome, total dose of colistin, repeated doses, and mode of drug delivery, organ support, organisms grown and their resistance. Response to colistin was judged by improvement in clinical status, decrease in white blood cell count (WCC) and inflammatory markers and no growth on cultures. The data were subjected to non-parametric Wilcoxon Signed Rank Test using SPSS version 14. Twenty-nine patients were included in the study all of whom received colistin in one form or the other. The average total dose of colistin was 69 million units (range 1-268). Of these, 17 patients survived (58.6%) and 12 died (41.4%). Twenty patients improved (69%) and 9 did not improve (31%) after administration of colistin. We also compared creatinine levels on admission and post colistin. We used non-parametric Wilcoxon Signed Rank test which showed no difference in the two groups (p = 0.38). We found colistin to be safe and effective in treating multi-resistant Gram-negative infections in burns patients and we did not see any statistically significant impairment of renal function.

Original languageEnglish (US)
Pages (from-to)522-527
Number of pages6
JournalBurns
Volume36
Issue number4
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

Fingerprint

Colistin
Burn Units
Burns
Critical Care
Nonparametric Statistics
Intensive Care Units
Infection
Renal Replacement Therapy
Leukocyte Count
Plastics
Length of Stay
Creatinine
Referral and Consultation
Retrospective Studies
Demography
Kidney

Keywords

  • Burns unit
  • Colistin
  • Gram-negative
  • Multi-resistant organisms

ASJC Scopus subject areas

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

Cite this

Use of colistin in treating multi-resistant Gram-negative organisms in a specialised burns unit. / Ganapathy, H.; Pal, S. K.; Teare, L.; Dziewulski, Peter.

In: Burns, Vol. 36, No. 4, 01.06.2010, p. 522-527.

Research output: Contribution to journalArticle

Ganapathy, H. ; Pal, S. K. ; Teare, L. ; Dziewulski, Peter. / Use of colistin in treating multi-resistant Gram-negative organisms in a specialised burns unit. In: Burns. 2010 ; Vol. 36, No. 4. pp. 522-527.
@article{1c3c4f858f3641eba3a2e29fb6590e53,
title = "Use of colistin in treating multi-resistant Gram-negative organisms in a specialised burns unit",
abstract = "Patients with burns are at an increased risk of infection which can affect their outcome-duration of hospital stay, intensive care requirements, organ support, inotrope requirements, renal replacement therapy, ventilatory requirements and overall mortality. Our study aimed to evaluate the use of colistin in our burns intensive care unit (ICU) in treating multi-resistant Gram-negative infections. This was a retrospective study carried out in a regional referral centre for burns and plastics, Chelmsford, UK. We looked at data from patients admitted to our intensive care over a two-year period from November 2003 to November 2005. All patients who received colistin were included in the study. Admission data included demographic data and burn data, other relevant medical history, and blood results. We also recorded: length of ICU stay, ultimate outcome, total dose of colistin, repeated doses, and mode of drug delivery, organ support, organisms grown and their resistance. Response to colistin was judged by improvement in clinical status, decrease in white blood cell count (WCC) and inflammatory markers and no growth on cultures. The data were subjected to non-parametric Wilcoxon Signed Rank Test using SPSS version 14. Twenty-nine patients were included in the study all of whom received colistin in one form or the other. The average total dose of colistin was 69 million units (range 1-268). Of these, 17 patients survived (58.6{\%}) and 12 died (41.4{\%}). Twenty patients improved (69{\%}) and 9 did not improve (31{\%}) after administration of colistin. We also compared creatinine levels on admission and post colistin. We used non-parametric Wilcoxon Signed Rank test which showed no difference in the two groups (p = 0.38). We found colistin to be safe and effective in treating multi-resistant Gram-negative infections in burns patients and we did not see any statistically significant impairment of renal function.",
keywords = "Burns unit, Colistin, Gram-negative, Multi-resistant organisms",
author = "H. Ganapathy and Pal, {S. K.} and L. Teare and Peter Dziewulski",
year = "2010",
month = "6",
day = "1",
doi = "10.1016/j.burns.2009.07.010",
language = "English (US)",
volume = "36",
pages = "522--527",
journal = "Burns",
issn = "0305-4179",
publisher = "Elsevier Limited",
number = "4",

}

TY - JOUR

T1 - Use of colistin in treating multi-resistant Gram-negative organisms in a specialised burns unit

AU - Ganapathy, H.

AU - Pal, S. K.

AU - Teare, L.

AU - Dziewulski, Peter

PY - 2010/6/1

Y1 - 2010/6/1

N2 - Patients with burns are at an increased risk of infection which can affect their outcome-duration of hospital stay, intensive care requirements, organ support, inotrope requirements, renal replacement therapy, ventilatory requirements and overall mortality. Our study aimed to evaluate the use of colistin in our burns intensive care unit (ICU) in treating multi-resistant Gram-negative infections. This was a retrospective study carried out in a regional referral centre for burns and plastics, Chelmsford, UK. We looked at data from patients admitted to our intensive care over a two-year period from November 2003 to November 2005. All patients who received colistin were included in the study. Admission data included demographic data and burn data, other relevant medical history, and blood results. We also recorded: length of ICU stay, ultimate outcome, total dose of colistin, repeated doses, and mode of drug delivery, organ support, organisms grown and their resistance. Response to colistin was judged by improvement in clinical status, decrease in white blood cell count (WCC) and inflammatory markers and no growth on cultures. The data were subjected to non-parametric Wilcoxon Signed Rank Test using SPSS version 14. Twenty-nine patients were included in the study all of whom received colistin in one form or the other. The average total dose of colistin was 69 million units (range 1-268). Of these, 17 patients survived (58.6%) and 12 died (41.4%). Twenty patients improved (69%) and 9 did not improve (31%) after administration of colistin. We also compared creatinine levels on admission and post colistin. We used non-parametric Wilcoxon Signed Rank test which showed no difference in the two groups (p = 0.38). We found colistin to be safe and effective in treating multi-resistant Gram-negative infections in burns patients and we did not see any statistically significant impairment of renal function.

AB - Patients with burns are at an increased risk of infection which can affect their outcome-duration of hospital stay, intensive care requirements, organ support, inotrope requirements, renal replacement therapy, ventilatory requirements and overall mortality. Our study aimed to evaluate the use of colistin in our burns intensive care unit (ICU) in treating multi-resistant Gram-negative infections. This was a retrospective study carried out in a regional referral centre for burns and plastics, Chelmsford, UK. We looked at data from patients admitted to our intensive care over a two-year period from November 2003 to November 2005. All patients who received colistin were included in the study. Admission data included demographic data and burn data, other relevant medical history, and blood results. We also recorded: length of ICU stay, ultimate outcome, total dose of colistin, repeated doses, and mode of drug delivery, organ support, organisms grown and their resistance. Response to colistin was judged by improvement in clinical status, decrease in white blood cell count (WCC) and inflammatory markers and no growth on cultures. The data were subjected to non-parametric Wilcoxon Signed Rank Test using SPSS version 14. Twenty-nine patients were included in the study all of whom received colistin in one form or the other. The average total dose of colistin was 69 million units (range 1-268). Of these, 17 patients survived (58.6%) and 12 died (41.4%). Twenty patients improved (69%) and 9 did not improve (31%) after administration of colistin. We also compared creatinine levels on admission and post colistin. We used non-parametric Wilcoxon Signed Rank test which showed no difference in the two groups (p = 0.38). We found colistin to be safe and effective in treating multi-resistant Gram-negative infections in burns patients and we did not see any statistically significant impairment of renal function.

KW - Burns unit

KW - Colistin

KW - Gram-negative

KW - Multi-resistant organisms

UR - http://www.scopus.com/inward/record.url?scp=77950516253&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77950516253&partnerID=8YFLogxK

U2 - 10.1016/j.burns.2009.07.010

DO - 10.1016/j.burns.2009.07.010

M3 - Article

VL - 36

SP - 522

EP - 527

JO - Burns

JF - Burns

SN - 0305-4179

IS - 4

ER -