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

Abstract

Background: Infections are a major problem in burns patients. Knowledge of the incidence and antimicrobial sensitivities of the microorganisms commonly encountered within each institution's burns unit is important as it informs and directs empiric antibiotic therapy.

Methods: This was a retrospective review of patients admitted from 1 January 2008 to 31 December 2012 to an adult burns intensive care unit. Specimens chosen for analysis were wound swabs, blood cultures, venous catheter tips, tracheal aspirates, sputum, urine and wound tissue. Records were accessed from the admission register and laboratory information system to obtain the relevant data.

Results: During the study period, 352 patients were admitted to the adult burns intensive care unit, of which, 341 patients were included. The mortality rate was 44.6%. Flame burns were the commonest. Mortality rate amongst patients with bacteremia was 46.9%. Acinetobacter baumannii, Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus (MRSA) were found to be the most common organisms cultured in most specimens.

Conclusion: The main three organisms identified in specimen cultures in our adult burns intensive care unit were A. baumannii, P. aeruginosa and MRSA. This study has helped establish a better empiric approach to the management of our septic burns patients.

Keywords: Antibiotic resistance; Bacteriology; Burns; Sepsis.