Antimicrobial resistance after burn injuries and severe skin disorders
The University of North Carolina is home to the North Carolina Jaycee Burn Center. This is a 36-bed facility with over 1,500 annual admissions that is verified by the American Burn Association for both adult and pediatric burn care. In addition to providing state-of-the-art burn care, the multidisciplinary team of the NC Jaycee Burn Center also provides comprehensive care to patients with severe skin disorders such as Stevens-Johnson syndrome.
Infections are the among the most feared complications in burn patients. Due to prolonged hospitalization and often ongoing need for life-saving medical interventions such as mechanical ventilation, patients are at high risk for acquiring multidrug-resistant bacteria (MDRO). The multidisciplinary burn infectious diseases (ID) research team at UNC is composed of burn and plastic surgeons, hospital epidemiologists, microbiologists, and infectious disease specialists. This team is responsible for several landmark publications in the field of burn-ID research. For instance, they were the first to outline the timeline of infections after burn injury.
Goals of this research are to define if and how MDRO spread from patient-to-patient and to determine risk factors for infection with MDRO. In addition, the prevention and optimal treatment of MDRO infections are topics of investigation. Our research team has access to comprehensive prospectively obtained data on burn patients from the infection prevention database (comprehensive database from 1978-present of all patients with a healthcare-associated infection), the burn database (detailed data on patient risk factors such as burn size and inhalation injury, and outcomes); and the Carolina Data Warehouse that includes detailed demographic and hospital data. Research methods include basic laboratory research, prospectively obtained cohort data, and intervention trials.
Bruce Cairns, MD, FACS
C. Scott Hultman, MD, MBA
Jon Juliano, MD, MSPH
Anne Lachiewicz, MD, MPH
Robert Maile, PhD
Sonia Napravnik, PhD
David van Duin, MD, PhD
David J. Weber
Felicia Williams, MD
Improving Research Enrollment of Severe Burn Patients.
Lachiewicz AM, Williams FN, Carson SS, Trexler JM, Nielsen CA, van Duin D, Weber DJ, Williams SD, Jones SW, Cairns BA.
J Burn Care Res. 2017 Sep/Oct;38(5):e807-e813.
From VAP to VAE: Implications of the New CDC Definitions on a Burn Intensive Care Unit Population.
Lachiewicz AM, Weber DJ, van Duin D, Carson SS, DiBiase LM, Jones SW, Rutala WA, Cairns BA, Sickbert-Bennett EE.
Infect Control Hosp Epidemiol. 2017 Jul;38(7):867-869. doi: 10.1017/ice.2017.63. Epub 2017 Apr 17. PMID:28413996
A Prolonged Outbreak of KPC-3-Producing Enterobacter cloacae and Klebsiella pneumoniae Driven by Multiple Mechanisms of Resistance Transmission at a Large Academic Burn Center.
Kanamori H, Parobek CM, Juliano JJ, van Duin D, Cairns BA, Weber DJ, Rutala WA. Antimicrob Agents Chemother. 2017 Jan 24;61(2). pii: e01516-16.
doi: 10.1128/AAC.01516-16. Print 2017 Feb. PMID: 27919898
Timeline of health care-associated infections and pathogens after burn injuries.
van Duin D, Strassle PD, DiBiase LM, Lachiewicz AM, Rutala WA, Eitas T, Maile R, Kanamori H, Weber DJ, Cairns BA, Napravnik S, Jones SW.
Am J Infect Control. 2016 Dec 1;44(12):1511-1516. doi: 10.1016/j.ajic.2016.07.027. Epub 2016 Oct 11. PMID:27742146