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[Ecological changes in burn wound bacterial flora].

W S Xu1

  • 1Shanghai Burn Institute, Rui Jin Hospital, Shanghai Second Medical University.

Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi = Zhonghua Zheng Xing Shao Shang Waikf [I.E. Waike] Zazhi = Chinese Journal of Plastic Surgery and Burns
|September 1, 1990
PubMed
Summary

Bacterial flora in burn wounds changed significantly between 1970-1971 and 1985-1986. Key shifts include reduced Pseudomonas aeruginosa and increased Enterobacter aerogenes, linked to antimicrobial use.

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Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Wound Care

Background:

  • Bacterial colonization of burn wounds poses a significant risk for infection and delayed healing.
  • Understanding shifts in bacterial flora is crucial for effective antimicrobial strategies.

Purpose of the Study:

  • To compare the bacterial ecology of burn wounds over two distinct time periods.
  • To identify changes in the prevalence of specific bacterial species and their potential correlation with antimicrobial usage.

Main Methods:

  • Comparative analysis of bacterial isolates from burn wound patients across two decades (1970-1971 vs. 1985-1986).
  • Identification and quantification of bacterial species, including Gram-positive cocci, Gram-negative bacilli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter anitratum, and Staphylococcus aureus.
  • Correlation of observed flora changes with the introduction of 1% silver sulfadiazine (since 1972) and third-generation cephalosporins (since 1983).

Main Results:

  • Gram-positive cocci incidence increased from 40.70% to 45.66%, while Gram-negative bacilli decreased from 54.92% to 48.10%.
  • Pseudomonas aeruginosa significantly decreased (35.08% to 11.26%), whereas Enterobacter aerogenes significantly increased (3.69% to 11.14%).
  • Klebsiella pneumoniae and Enterobacter cloacae, previously rare, showed increased incidence (3.79% and 3.06% respectively). Acinetobacter anitratum also increased (1.38% to 3.30%).
  • Methicillin-resistant Staphylococcus aureus (MRSA) constituted a high proportion (73.4%) of Staphylococcus aureus isolates in a later period (1986-1987).

Conclusions:

  • Antimicrobial stewardship, specifically the introduction of silver sulfadiazine and third-generation cephalosporins, has demonstrably altered the bacterial landscape of burn wounds.
  • The rise in specific resistant organisms like MRSA and the changing prevalence of Gram-negative bacilli highlight the ongoing challenge of managing burn wound infections.

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