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.
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