Infection control in a third world burn facility

Microbiology and antibiotic resistance in severe burns patients: A 5 year review in an adult burns unit

“…A previous small study performed in Durban identified Staphylococcus aureus, Klebsiella sp. and P. aeruginosa as the most common organisms [2]. Most of these organisms were also described in a study in the United States [10].…”

“…Following ethical clearance from the Ethics Committee of the University of Witwatersrand, information on patients admitted to ABICU was collected from the admission register of the unit: hospital number, age, gender, length of stay, outcome (death or discharge), total body surface area burn percentage (TBSA), mechanism of burn. The following categories of patients were excluded: (1) patients stepped up from the adult burns ward to ABICU during their admission, (2) patients that died within 24 h of admission, (3) patients whose data was not accessible or incomplete due to clerical errors. The National Health Laboratory Services (NHLS) laboratory information system was then accessed to obtain microbiological culture results and antibiotic sensitivities.…”

“…The reasons for increased susceptibility to infection include a generalized immune deficit due to impaired function of both the cellular and humoral immune systems, loss of the protective skin barrier and the massive systemic inflammatory response syndrome (SIRS) causing general systemic disarray [2]. The Nosocomial Infection Surveillance System from the United State Centers for Disease Control and Prevention (CDC) in 2001, demonstrated that amongst all intensive care units (ICUs), burn centres have the highest rates of primary blood stream infection in patients with central venous catheters [3].…”

Bacterial and Antimicrobial Susceptibility Profile, and Prevalence of Sepsis Among Burn Patients at the Burn Unit of Cipto Mangunkusumo Hospital

“…2 The higher susceptibility to infection among burn patients is usually caused by an impaired immune system as destruction of the skin, which serves as a barrier to infection, occurs; there is also a high level of systemic inflammatory response (SIRS). 3 One major principal in the management of burn infections is the appropriate use and choice of antimicrobial therapy. 14 Unfortunately, over the last 10 years the pattern of antimicrobial sensitivity and bacterial infection profile in many burn units has changed significantly.…”

“…2 Stud-ies have shown that the occurrence of sepsis in burn patients is caused by a depression in the immune response (cellular and humoral) and massive systemic inflammatory response (SIRS). 3 Additional contributors to the occurrence of sepsis in burn patients is high cutaneous bacterial load, the possibility of gastrointestinal bacterial translocation, prolonged hospitalization, and invasive diagnostic and therapeutic procedures. 4,5 However, with the increasing prevalence of drug-resistant…”