859The Epidemiology of Bloodstream Infections in a Tertiary Care Burn ICU Over a 5 Year Period
Bibliographic record
Abstract
Background. Infections continue to be the leading cause of death among burn patients, and many types of nosocomial infections (NIs) can be present in the burned patient. The presence of bloodstream infections (BSI) has been shown to result in a four-fold increase in mortality in this population. The purpose of this study is to review the rates and epidemiology of hospital acquired bloodstream infections in a tertiary care center burn unit over a five year period from 2009-2013. We also assessed risk factors that have been associated with a documented increase in the number of BSI in 2013 at our institution. Methods. This study is a retrospective cohort study conducted at a 650 bed tertiary care hospital in Edmonton, Canada. All patients admitted to the burn ICU and had a nosocomial bloodstream infection (defined according to CDC criteria) from January 2009 to December 2013 were included. Charts were then reviewed for additional epidemiologic data. Results. Twenty one patients developed 30 episodes of BSI. The majority of BSIs were associated with skin/burn infection (13/30). Eight episodes were classified as central-line associated BSI, making this the second most common cause of BSI. In 2013 the BSI rate increased dramatically to 58.18 per 1,000 admissions, compared with an average rate of 9.56 (8.9-10.07) per 1,000 admissions from 2009-2012. This was associated with increased median length of hospital stay (25.57 days vs 96.75 days) and burn severity (TSB: 58% vs 85%). The most common pathogen isolated was Pseudomonus aeruginosa (7/30). There were seven episodes of multidrug resistant BSIs. All multidrug resistant (MDR) BSIs were seen > 4 weeks after admission. The mortality rate in the bacteremic group was 13%. Conclusion. Burn patients are at high risk for BSI and this is closely related to % TBSA and length of hospitalization. The mortality is associated with severity of burn injury, older age and resistant pathogen bacteremia. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".