ẢNH HƯỞNG CỦA NHIỄM VI KHUẨN ĐA KHÁNG ĐẾN KẾT QUẢ ĐIỀU TRỊ Ở BỆNH NHÂN BỎNG NẶNG

Abstract

Objectives: To evaluate the impact of multidrug-resistant bacterial (MDRb)  infections on mortality rate, superficial wound healing time, and treatment costs among patients with severe burns. Methods: A prospective, descriptive, longitudinal study was conducted on 131 severe burn patients treated at the Intensive Care Unit (ICU), National Burn Hospital Le Huu Trac, from January 2023 to December 2023. A total of 744 clinical specimens (blood, wound exudate, and urine) were analyzed. Results: Deep burn surface area and MDRb bloodstream infections were independently associated with mortality (p < 0.05). Each 1% increase in deep burn area was associated with a 1.07-fold increase in mortality risk, while the presence of MDRb in blood increased the risk 8.03-fold after adjustment for other factors. MDRb bloodstream infection showed moderate prognostic value for mortality (AUC = 0.75), with a sensitivity of 55.77% and a specificity of 93.67%. Patients with MDRb infection had significantly longer ICU stays, prolonged superficial wound healing, and higher treatment costs per 1% total burn surface area compared to those without MDR infections (p < 0.01). Conclusion: MDRb infections significantly increase mortality, prolong wound healing time, and elevate treatment costs in severe burn patients (p < 0.05). MDRb-positive blood cultures are an independent prognostic factor for mortality (p < 0.01).