Nosocomial infections among burn patients in Teheran, Iran: a decade later

The aim of this study was to determine the epidemiology of nosocomial infections among burn patients in a tertiary burn care centre in Tehran, Iran. A cross-sectional study was carried out during a 6-month period from August 2010 to January 2011 at Motahari Burn and Reconstruction Center in Tehran. Of 155 patients, 677 samples of wound and blood were taken for culture during the course of hospitalization. The rate of positive culture during the 1(st), 2(nd), 3(rd), and 4(th) week of hospitalization were 76.3%, 99.3%, 100%, and 100%, respectively. On the 2(nd), 3(rd), and 4(th) week of hospitalization, Pseudomonas aeruginosa was the most common pathogen followed by Acinetobacter, while the culture positive rate for Staphylococcus spp., Enterobacteriaceae, and Enterococcus spp. significantly decreased (P < 0.001). In this study, 70 patients out of 155 (45.2%) had at least one Acinetobacter positive culture. Our results showed that P. aeruginosa is still the leading cause of nosocomial infections. Additionally, Acinetobacter has appeared as an emerging nosocomial pathogen, and should be considered as a serious risk. We believe that changes in burn wounds' bacterial colonization over time require consistent assessment and monitoring of these changes in any burn center.