To investigate the risk factors for Acinetobacter baumannii (Ab) bloodstream infection in patients with severe burns, analyze the prognosis of patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection, and to assess the predictive value of infection-related indicators for the prognosis of severe burns patients with CRAB bloodstream infection.

A total of 212 patients with severe burns and diagnosed with bloodstream infection in the Burn Plastic and Wound Repair Medical Center, the First Affiliated Hospital of Nanchang University from January 2014 to December 2021 were selected for the study, and were divided into the Ab bloodstream infection group (102 cases) and the non-Ab bloodstream infection group (110 cases) according to the different bacteria of bloodstream infection, and the clinical data of the two groups were compared to explore the risk factors for Ab bloodstream infection in patients with severe burns. A total of 98 patients with CRAB bloodstream infection were selected from the Ab bloodstream infection group, and were divided into a poor prognosis group (50 cases) and a good prognosis group (48 cases) according to the prognosis. The risk factors associated with poor prognosis were analyzed by comparing the different clinical data of the two groups, and the predictive value for the prognosis of patients with CRAB bloodstream infection was evaluated by comparing the infection-related indexes of the two groups within 48 hours after diagnosis.

Analysis of the Ab bloodstream infection group versus the non-Ab bloodstream infection group showed that combined Ab infection at other sites (OR=1.859, 95%CI: 1.034-3.344, P=0.038), combined shock (OR=1.926, 95%CI: 1.086-3.414, P=0.025) and duration of arterial cannulation (OR=1.028, 95%CI: 1.002-1.055, P=0.034) were independent risk factors for Ab bloodstream infection in patients with severe burns. Comparison between the good and poor prognosis groups showed that prolonged mechanical ventilation (OR=1.068, 95%CI: 1.018-1.121, P=0.007), large full-thickness burn area (OR=1.081, 95%CI: 1.034-1.130, P=0.001) and advanced age (OR=1.074, 95%CI: 1.014-1.137, P=0.015) were independent factors influencing poor prognosis in burns patients with CRAB bloodstream infection. Receiver operating characteristic (ROC) curves showed that the area under the curve for platelets (PLT), procalcitonin (PCT) and PLT combined with PCT to predict poor prognosis in burns patients with CRAB bloodstream infection was 0.779(95%CI: 0.677-0.880, P<0.001), 0.720(95%CI: 0.604-0.836, P=0.001) and 0.836(95%CI: 0.750-0.923, P<0.001).

Concomitant Ab infection at other sites, combined shock and duration of arterial cannulation are risk factors for Ab bloodstream infections in patients with severe burns. Prolonged mechanical ventilation, large full-thickness burn area burns and advanced age are factors affecting the poor prognosis of burn patients with CRAB bloodstream infection. PLT and PCT levels have some predictive value for the prognosis of burn patients with CRAB bloodstream infection.