Incidence and Bacteriology of Burn Infections at a Military Burn Center
BROOKE ARMY MEDICAL CENTER FORT SAM HOUSTON TX
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Considerable advancements in shock resuscitation and wound management have extended the survival of burned patients, increasing the risk of serious infection. We performed a 6-year review of bacteria identification and antibiotic susceptibility records at the US Army Institute of Surgical Research Burn Center between January 2003 and December 2008. The primary goal was to identify the bacteria recovered from patients with severe burns and determine how the bacteriology changes during extended hospitalization as influenced by population and burn severity. A total of 460 patients were admitted to the burn ICU with 3507 bacteria recovered from 13,727 bacteriology cultures performed. The most prevalent organisms recovered were Acinetobacter baumannii 780, Pseudomonas aeruginosa 703, Klebsiella pneumoniae 695 and Staphylococcus aureus 469. A. baumannii was most often recovered from combat-injured 58 and S. aureus the most frequent isolate from local 46 burn patients. Culture recovery rate of A. baumannii and S. aureus was highest during the first 15 hospital days 73 and 71 while a majority of P. aeruginosa and K. pneumoniae were recovered after day 15 63 and 53. All 4 pathogens were recovered throughout the course of hospitalization. A. baumannii was the most prevalent pathogen recovered from patients with total body surface area TBSA burns less than 30 203 and 30-60 338 while P. aeruginosa was most prevalent in patients with burns greater than 60 TBSA 292. Shifting epidemiology of bacteria recovered during extended hospitalization, bacteriology differences between combat- injured and local burn patients, and impact of TBSA may affect patient management decisions during the course of therapy.
- Medicine and Medical Research