Epidemiology and bacterial colonization of burn injuries in Blantyre

Forty-nine patients from the Burns Unit at the QECH had swabs taken from various sites in order to determine the bacterial profile and antibiotic susceptibilities in burn wounds colonized by bacteria. The mean age was 16 years (range 1-70 years); 27 (55 %) of the study population were female and 22 (45%) were male. Twenty-four (49%) patients were epileptic. Open fire (41%) was the most common cause of burn injuries among epileptics while hot water burns (29%) were commonest among non-epileptics. Burn injury and percentage total burn surface area (% TBSA) injuries decreased with age, and the upper and lower limbs, trunk, head and neck were the most commonly affected sites. Staphylococcus aureus was the commonest isolate (23%), followed by Proteus mirabilis (22.7%), Streptococci spp (15.9%), Pseudomonas aeruginosa (4.5%) and 3.4% for Escherichia coli, Salmonella and Klebsiella spp. There was a significant trend of bacterial growth with increasing % TBSA (p<0.001). Bacterial growth was significantly more common in more recent burns of less than 20 days compared to burns of longer duration (OR 4.1 [95% CI 1.58-10.99]). Broad-spectrum antibiotics are required as first-line therapy for burns-related sepsis but there is need for surveillance of antibiotic susceptibility to help determine appropriate therapy.