To investigate the clinical characteristics and risk factors of bloodstream infection and to provide basis for constructing the risk model of bloodstream infection in patients with severe burn combined with inhalation injury in the future.

Clinical data of 185 patients who met the inclusion criteria in Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1, 2010 to December 31, 2019 were retrospectively analyzed. Demographic characteristics, burn condition, transfer condition, characteristics of bloodstream infection and prognosis, treatment and outcome were analyzed. The patients were divided into infected group (n=62, 33.51%) and uninfected group (n=123, 66.49%) according to whether or not they had bloodstream infection. The characteristics of bloodstream infection and the risk factors of bloodstream infection in these patients were analyzed through Mann-Whitney U test、χ² test and Logistic regression analysis.

Sixty-two of the 185 patients with severe burn combined with inhalation injury had bloodstream infection. The top three bacteria with positive rate from high to low were Klebsiella pneumoniae (36.25%), Pseudomonas aeruginosa (28.75%) and Acinetobacter baumannii (13.75%). Compared with non-infection group, the total burn area, full-thickness burn area, ICU length of stay and length of hospital stay of infection group were obviously higher than the non-infection group, the differences were statistically significant(Z= 4.361, 4.652, 4.297, 2.769; P< 0.05). The constituent ratio of male and receiving mechanical ventilation were higher in infection group, the differences were statistically significant(χ²=4.237, 13.788; P< 0.05). Further logistic regression analysis showed that ICU length of stay was the independent risk factor for the severe burn patients combined with inhalation injury (odds ratio=1.035, 95% confidence interval=1.014-1.057, P< 0.05).

The incidence of bloodstream infection was high in patients with severe burn combined with inhalation injury, and the main pathogens was Gram-negative bacteria, especially Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. The ICU length of stay was an independent risk factor for bloodstream infection in patients with severe burn combined with inhalation injury.