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These challenges are exacerbated in immunocompromised hosts, such as those with burn injury. This study sought to describe the epidemiology and associated clinical outcomes of burn wound colonization in a Malawian tertiary burn center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a prospective analysis of burn patients presenting to Kamuzu Central Hospital in Lilongwe, Malawi, within 72 h of burn injury. A swab of each patient\u2019s primary wound was collected at admission and each subsequent week. The primary exposure was burn wound colonization with MDR bacteria, particularly\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      . The primary outcome was in\u2010hospital mortality. A log binomial model estimated the association between the exposure and outcome, adjusted for confounders.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010nine patients were enrolled with a median age of 4 years (IQR 2\u201312) and a male preponderance (54%). Median total body surface area burn (TBSA) was 14% (IQR 9\u201325), and crude in\u2010hospital mortality was 19%.\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      were the most common MDR bacteria with 36% of patients becoming colonized. Wound colonization with MDR\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      was associated with increased in\u2010hospital mortality with a risk ratio of 1.86 (95% CI 1.38, 2.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) adjusted for TBSA, burn type (scald vs. flame), sex, age, length of stay, and methicillin\u2010resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      colonization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      MDR bacteria, especially\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      , are common and are associated with worse burn injury outcomes. In resource\u2010poor environments, a greater emphasis on prevention of MDR bacterial colonization, improved isolation precautions, affordable diagnostics, and antibiotic stewardship are imperative.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-018-4633-7","type":"journal-article","created":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T14:05:55Z","timestamp":1524665155000},"page":"3089-3096","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Colonization with Multidrug\u2010Resistant\n                    <i>Enterobacteriaceae<\/i>\n                    is Associated with Increased Mortality Following Burn Injury in Sub\u2010Saharan Africa"],"prefix":"10.1002","volume":"42","author":[{"given":"Jared R.","family":"Gallaher","sequence":"first","affiliation":[{"name":"Department of Surgery School of Medicine University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wone","family":"Banda","sequence":"additional","affiliation":[{"name":"Department of Surgery Kamuzu Central Hospital Lilongwe Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Lachiewicz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases School of Medicine University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Krysiak","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases School of Medicine University of North Carolina Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Cairns","sequence":"additional","affiliation":[{"name":"North Carolina Jaycee Burn Center, Department of Surgery, School of Medicine University of North Carolina 4008 Burnett Womack Building, CB# 7600 Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony G.","family":"Charles","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine University of North Carolina Chapel Hill NC USA"},{"name":"Department of Surgery Kamuzu Central Hospital Lilongwe Malawi"},{"name":"North Carolina Jaycee Burn Center, Department of Surgery, School of Medicine University of North Carolina 4008 Burnett Womack Building, CB# 7600 Chapel Hill NC USA"},{"name":"School of Medicine University of North Carolina 4008 Burnett Womack Building, CB 7228 Chapel Hill USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,25]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2011.03.001"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/524891"},{"key":"e_1_2_10_4_2","unstructured":"World Health Organization(2014)Antimicrobial resistance: 2014 global report on surveillance.http:\/\/apps.who.int\/iris\/bitstream\/10665\/112642\/1\/9789241564748_eng.pdf. 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The authors have no financial relationships to disclose. A.M.L.: Destum Partners and KPB Biosciences, Consulting. GlaxoSmithKline, Research funding. No other disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}