IMPACT OF ACINETOBACTER INFECTION ON THE MORTALITY OF BURN PATIENTS

After carefully reading of the abstracts obtained from a literature search of disease topic answer the questions mention below. 

IMPACT OF ACINETOBACTER INFECTION ON THE MORTALITY OF BURN PATIENTS

Albrecht MA, Griffith ME Murray CK, et al.

Background: Acinetobacter calcoaceticus-baumannii complex (Acb) is recognized as an 

important cause of nosocomial infections. Although Acb can be associated with 

multidrug resistance, its impact on mortality in burn patients has not been fully 

elucidated.

Study Design: In a [ ] study assessing medical records and microbiology 

laboratory data at a US military tertiary care burn center, we evaluated all patients 

admitted to the burn center between January 2003 and November 2005. Data collected 

included age, severity of burn, comorbidities, length of stay, and survival to hospital 

discharge. In addition, microbiology data were reviewed to determine which patients 

were infected with Acb during this time frame. These were then used to compare 

patients infected with Acb to patients not infected. Multivariate analysis using logistic 

regression was performed to determine which patient characteristics were associated 

with increased mortality.

Results: There were 802 patients included in the study. Fifty-nine patients met 

the case definition for infection. An additional 52 patients were found to be colonized 

with Acb. Patients with Acb infection had more severe burns and comorbidities, and had 

lnger lengths of stay compared with patients without Acb or those with Acb 

colonization. Mortality in infected patients as higher compared with those without infection (relative risk 2.86, p<0.001). On multivariate analysis, infection with Acb was not statistically associated with mortality.

Conclusions: Multidrug-resistant Acb is a common cause of nosocomial infection 

in the burn patient population. Despite this, it does not independently affect mortality.

J Am Coll Surg 2006;203:546-550.

1. What is the epidemiologic study design?

2. (a) Identify the exposure(s) of interest (independent variables) and (b) the 

outcome(s) (dependent variables) of interest in the study. 

3. (a) Suggest at least one possible bias (systematic error) that might be present in 

each study. Pay particular attention to how subjects were selected, and what 

information was gathered from them and how it was collected. (b) Explain 

specifically how this could introduce bias into the study.

4. (a) Suggest one or more possible confounding factors related to the data 

collected and analyzed in the study, and (b) explain how it/they might confound 

interpretation of the authors’ findings.

5. (a) Suggest at least one other epidemiologic study design that could address the 

same question(s), and (b) discuss the relative strengths and limitations of the 

other study design compared to the one actually used.