5 year analysis of bacteriology culture in a tropical burns ICU

Infection is a major cause of morbidity and mortality in burns patients.

A retrospective review of all 94 patients admitted to a regional burns ICU from 2004 to 2009 was performed. All the patients' data and records of all culture isolates from a computerized hospital wide database were studied. Epidemiology of the patients, bacteriology information including yield and correlation of bacteremia with positive cultures from other sites were examined. In addition, the relationship between burns excision surgeries to bacteremia was analyzed.

402 tissue cultures, 238 wound swab cultures, 269 endotracheal cultures, 125 urine cultures, 236 tip of monitoring line cultures and 474 blood cultures were studied. Acinetobacter baumannii was the most prevalent bacteria for all culture methods. Within 24 h of bacteremia, the tissue, line tips, endotracheal and wound swab cultures had yielded very similar pathogens (>70% of the time) to those from the blood stream. Furthermore 60% of all bacteremic episodes occur within 48 h of the surgery.

In ICUs where multidrug resistant pathogens are endemic, the choice of appropriate antimicrobial empiric cover should be guided by the intensity of colonization with these organisms as indicated by the cultures from various sites.