Study of Results of Bacterial Culture and Antibiotic Sensitivity in Burn Patients / 대한피부과학회지

ABSTRACT

BACKGROUND: As a result of the extensive changes in burn care over the last few decades, including prevention of infection, burn survival has greatly increased. However, infection is still one of the main causes of death in severe burn cases, despite the progression in intensive care. But no recent comprehensive survey of infection has been carried out. OBJECTIVES: This retrospective study of bacteriological profile and antibiotic sensitivity patterns of isolates from a burn unit was carried out to provide burn care to plan future steps to reduce further the incidence of sepsis. METHODS: A retrospective review of burn wound infection in 623 patients treated in the burn center at the Hangang Sacred Heart Hospital, over a 2-year period (1998 - 2000) was carried out. RESULTS AND CONCLUSIONS: From wound cultures, Pseudomonas aeruginosa was most commonly isolated (24.7%) followed by Staphylococcus aureus (15.8%), Acinetobacter baumannii (14.5%), Enterococcus faecium (10.4%), Enterococcus faecalis (9.1%), coagulase negative staphylococcus (7.7%), Escherichia coli (6.6%), alpha-hemolytic streptococcus (5.3%), Klebsiella spp. (3.9%), Candida (3.2%), Serratia marcescens (2.9%), and Proteus spp. (2.1%). The most common isolate from blood cultures was Staphylococcus aureus (39.9%) followed by Enterococcus faecium (17.2%), coagulase negative staphylococcus (8.7%), Pseudomonas aeruginosa (7.5%), Enterococcus faecalis (4.7%), Candida (3.7%), Acinetobacter baumannii (3.7%), Serratia marcescens (3.5%), Enterobacter aerogens (2.8%), and Enterobacter cloaca (2.8%). The concordance rate of the results of the wound culture and blood culture was 96.0% in the Pseudomonas aeruginosa, 51.3% in the Staphylococcus aureus, 16.7% in the Enterococcus faecalis, 10.5% in the coagulase negative staphylococcus. Vancomycin and teicoplanin were effective in 100% of gram-positive organism. The drugs effective in gram-negative organism were cefepime, aztreonam, imipenem, piperacillin+tazobactam, ticarcillin+clavulanic acid, and amikacin.