Analysis of the bacterial infections in burn patients at Taleghani Burn Hospital in Ahvaz, Khuzestan province

Background: The major challenge for a burn team is nosocomial infection, which is known to be responsible for over 50% of burn-related deaths. Most studies on infection in burn patients focus on burn wound infection, whereas other nosocomial infections among these patients have not been addressed well. This study attempts to determine three types of nosocomial infections: burn wound, urinary tract, and blood stream infections on the basis of National Nosocomial Infection Surveillance System (NNIS) definition. Materials and methods: During an academic year (May 2003 to April 2004), 182 patients were included. Blood, urine and wound biopsy samples were taken 7 and 14 days following the admission. Isolation and identification of microorganisms were performed according to the reference procedures. Susceptibility testing was carried out using disk diffusion procedure as recommended by Clinical and Laboratory Standard Institute. Results: Of 182 patients, 140 (76.9%) acquired at least one type of infection. A total of 116 patients (82.8%) were culture positive on day 7th while 24 (17.2%) were positive on day 14th. Primary wound infection was the most common infection (72.5%), followed by blood stream (18.6%) and urinary tract infections (8.9%). The most frequent microorganisms were pseudomonas aeruginosa (37.5%), staphylococcus aureus (20.2%), and acinetobacter baumanni (10.4 %). Among these isolates, P. aeruginosa was found to be 100% resistant to amikacin, gentamicin, carbenicillin and ciprofloxacin. It is worth to note that 58% of S. aureus and 60% of coagulase-negative staphylococcus isolates were methicillin resistant (MRSA). Conclusion: High prevalence of nosocomial infections, presence of multi-drug resistant bacteria, and MRSA are serious health concerns in burn patients at Taleghani hospital. We, therefore, concluded that continuous surveillance of burn infections is warranted in this high-risk group of patients in order to develop strategies for antimicrobial resistance control and treatment of infectious complications.