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Alejandra González De la Torre, Paola De la Parra Colin, Alejandra Gonzalez Veliz, Vania Paloma Zarza Garcia, Rafael Franco Cendejas; Changes in Ocular Surface Colonization in Hospitalized Patients in a Burn Unit. Invest. Ophthalmol. Vis. Sci. 2020;61(7):376.
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To evaluate the ocular surface colonization by pathogenic microorganisms in hospitalized patients in a burn unit throughout their hospital stay, as well as to determine their association with the use of sedation, assisted mechanical ventilation, and periocular burns.
We longitudinally evaluated hospitalized patients at the National Burns Center for Research and Care (CENIAQ) over a period of 8 months. Five evaluations were performed for each patient, one upon admission and then every week up to 4 times or until discharge or death. At each evaluation, we performed a conjunctival cul-de-sac swab for microbiological assessment. In addition, we evaluated the degree of eyelid occlusion, Bell’s reflex, Schirmer’s test, presence of chemosis, degree of conjunctival hyperemia and corneal fluorescein staining. Also, demographic and clinical variables were considered for the analysis.
Forty patients were evaluated, 28 men and 12 women with an average age of 37.2 ± 14.4 years. Thermal burn was the most frequent type in 65% of cases, 60% had facial involvement and 55% had involvement of the periocular region. The mean percentage of body surface area burned was 34.8% ± 23% and the mean hospital stay length was 25.5 ± 13.2 days. Colonization of the ocular surface by pathogens occurred at the 7th day of hospitalization in 25% of patients and at the 15th day of hospitalization in 50% of patients. The most frequent organism in positive cultures was Candida parapsilosis, followed by Pseudomonas areuginosa and Acinetobacter baumanii, among others. In the survival analysis, assisted mechanical ventilation showed an association (HR 5.8, 95% CI 1.3, 24.9, p=0.01) with pathogenic colonization of the ocular surface.
An increased length of hospital stay and assisted mechanical ventilation seem to be risk factors for the pathogenic colonization of the ocular surface in hospitalized patients in a burn unit.
This is a 2020 ARVO Annual Meeting abstract.
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