ABSTRACT
BACKGROUND: Healthcare-associated infections (HAIs) remain a major challenge in burn research and care. We aimed to describe the epidemiology and timeline of HAIs and to estimate the association of demographics and clinical characteristics with time to HAI among burn patients. METHODS: A prospective cohort study was conducted in a referral burn unit in southwestern Colombia. Incidence rates were calculated for HAI types and microorganisms, using a Poisson regression model. Univariable and multivariable Cox proportional hazards regression was used to estimate the effect of risk factors on time to first HAI. RESULTS: Of 165 burn patients, 46 (27.9%) developed at least one HAI (incidence rate of 21.8 per 1000 patient-days). The most frequent HAIs were burn wound infections, followed by bloodstream infections. The most common microorganisms were Staphylococcus aureus, Pseudomonas spp., and Acinetobacter baumannii. Whereas gram-negative bacteria were the most common microorganisms causing HAIs, gram-positive bacteria were the first microorganisms isolated after hospital admission. The independent risk factors associated with time to first HAI were burn size (TBSA>20%), burn mechanism (flames and scalds), central venous catheter use, and mestizo race. CONCLUSION: These data have implications toward generating empirical antibiotic guidelines and preventive strategies targeting the patients at highest risk for HAI.
Subject(s)
Burns/complications , Cross Infection/etiology , Time Factors , Time-to-Treatment/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Burn Units/organization & administration , Burn Units/standards , Burn Units/statistics & numerical data , Burns/epidemiology , Chi-Square Distribution , Child , Child, Preschool , Cohort Studies , Colombia/epidemiology , Cross Infection/epidemiology , Female , Humans , Infant , Male , Middle Aged , Poisson Distribution , Proportional Hazards Models , Prospective Studies , Risk Factors , Time-to-Treatment/standardsABSTRACT
Anisakiasis is a parasitic infection caused by larval stages of nematodes of the genus Anisakis, Pseudoterranova and Contracaecum, of the Anisakidae family. The lifecycle of these nematodes develops in aquatic organisms and their final hosts are marine mammals. However, humans can act as accidental hosts and become infected with infective stage larvae (L3) by consuming raw or undercooked fish or shellfish carrying the parasite. Of this group of parasites, the genus Anisakis is the most studied: its presence in humans is associated with non-specific gastrointestinal symptoms or allergic responses that can trigger anaphylactic shock. The lack of studies in anisakiasis and Anisakis in Colombia has resulted in this infection being little-known by medical practitioners and therefore potentially underreported. The objective of this study was to identify anisakid nematodes in the flathead grey mullet fish (Mugil cephalus), caught by artisanal fishing methods and commercialized in Buenaventura. Morphological identification was carried out by classical taxonomy complemented by microscopy study using the histochemical technique Hematoxylin-Eosin. Nematodes of the genus Anisakis were found in the host M. cephalus. The Prevalence of Anisakis larvae in flathead grey mullet fish was 33%. The findings confirm the presence of Anisakis sp. in fish for human consumption in the Colombian Pacific region, a justification for further investigation into a possible emerging disease in this country.
