RESUMO
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.
Assuntos
Queimaduras/microbiologia , Resistência Microbiana a Medicamentos , Infecção dos Ferimentos/microbiologia , Adulto , Idoso , Antibacterianos/farmacologia , Bacteriemia/microbiologia , Bacteriemia/mortalidade , Unidades de Queimados/estatística & dados numéricos , Queimaduras/tratamento farmacológico , Queimaduras/mortalidade , Feminino , Humanos , Incidência , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , África do Sul/epidemiologia , Infecção dos Ferimentos/tratamento farmacológicoRESUMO
The major challenge facing South African burn surgeons is the current and future management of major burns. Survival is greatly dependent on adequate therapeutic measures. Various therapeutic measures can be instituted to overcome the shortage of donor skin, as we describe. Each of these methods has its specific role in the management of major burns. The use of very expensive and highly specialised techniques for individual patients cannot be justified when more accessible and cost-effective methods are available. To serve the greater population of burn victims, every effort should be made to use these available methods rather than channelling scarce financial resources into procedures that have a very limited role in South Africa.
