Burn wound infection; significance of rule of nine in microbial surveillance

Burn injuries are common and major health problem throughout the world. The burn wound represents as a favorable area for opportunistic colonization of microorganisms with exogenous and endogenous origin. In burns patients infections arise from multiple sources. Burn wounds become initially colonized and infected with Gram positive bacteria, mainly Staphylococci, that are superseded during the second week by Gram Negative bacteria. it is a microbial surveillance retrospective study; that aimed to evaluate the significance of Rule of nine in diagnosis of aerobic bacterial burn wound infection and carried out in between June 2007 to September 2011 in the Department of Pharmaceutics, University of Karachi.Descriptive retrospective study. A total of 118 patient irrespective of age, sex, date and time of burn, date and time of hospital admission, interval between time of burn and hospital admission, degree and percentage [%] of burn and duration of hospital stay [when specimen collected] were registered for this study. All patients were divided into two groups [A and B]. Out of 58 patients of group A isolation rate per patient was 1.1 while in group B it becomes 3.0. According to TBSA the isolation rate in group B rises with rise in TBSA. Most prevalent organism in these patients was found S. aureus[23%] P.aeruginosa[21%]. Burn patients are incubator for variety of aerobic bacteria and rate of isolation of these organisms increase with rise in TBSA. The wounds of these patient must required continuous microbial surveillance that may reduce the rate of mortality

Effectiveness of beta lactam antimicrobial drugs against gram negative bacteria

To study the micro flora in wounds of the burn patients from three tertiary care medical hospitals in Karachi. In burn patient infections arise from multiple sources and infect burn wounds by a variety of micro-organisms. Gram negative bacterial infection results from translocation from colon, further more burn patients are infected by Hospital acquired bacteria by various invasive and non invasive procedures. July 2002 to December 2002. This study was conducted at the Department of Microbiology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Observational study. A retrospective study of fifty five patients with burn wound infection was carried out at burn units of Civil Hospital Karachi, National Institute of Child health Karachi and Abbasi Shaheed Hospital, Karachi. Patients who received burn injuries with clinical signs and symptoms of infection were included in this study. In the present study 46[29%] isolates of P. aeruginosa were recovered, in which most strains were MDR and their sensitivity against Imipenem was 38 [78%]. The over all prevalence of the Oxidase negative Gram negative coli form bacteria was more than 70%, in which the most prevalent organism belongs to Proteus Spp;[27%] follows the Enterobacter Spp;.[15.5%]. Bacteria belongs with family Enterobacteriacae were more prevalent i.e. >70% while P. aeruginosa was individually more prevalent than any member of family Enterobacteriacae and was most resistant to multiple antibiotics than any other bacteria. Imipenem was the most effective drug against all gram negative bacteria follows the 4[th]. generation Cephalosporin Cefepime