Microbial colonization in a new intensive care burn unit. A prospective cohort study

Area of Science:

• Infection Control
• Burn Care
• Microbiology

Background:

• Renovation of an intensive care burn facility necessitated temporary closure.
• An interim eight-bed open intensive care ward (B) was established.
• The renovated unit (A) featured single-bed intensive care rooms and intermediate care beds.

Purpose of the Study:

• To compare microbial colonization in patients treated in a new cohort-separated intensive care unit (A) versus an interim ward (B).
• To assess the impact of cohort separation on the incidence of antibiotic-resistant organisms and bacterial cross-contamination.

Main Methods:

• A comparative study of the first 25 admissions to the renovated unit (A) and the last 25 admissions to the interim ward (B).
• Microbial colonization monitored via regular sputum, wound, stool, and urine cultures.
• Analysis of gram-negative colonization and antibiotic-resistant organism occurrence.

Main Results:

• Both cohorts showed similar incidences of gram-negative wound, sputum, and urine colonization.
• The occurrence of antibiotic-resistant organisms was comparable between the two units.
• No bacterial cross-contamination was detected between unit A and ward B.
• Endemic strains of Providencia stuartii and Pseudomonas aeruginosa persisted in ward B.

Conclusions:

• Cohort separation in burn intensive care units may effectively eliminate endemic resistant gram-negative organisms.
• The new unit (A) experienced colonization with new, distinct gram-negative organisms.
• Cohort separation appears to be a practical strategy for infection control in burn units.