Transient and resident microflora of burn unit personnel and its influence on burn wound sepsis

The exogenous contamination of a thermally injured patient by contact with the health are team has been a major concern of all burn units. Since the University of Chicago Burn Center routinely monitors each burn injury for sepsis by quantitative bacteriology and recently examined the microbial population present on the hands of the health care team, it was felt that these combined data would shed some pertinent information on exogenous burn wound sepsis. Twenty-nine patients with clinical burn wound sepsis and a bacterial level of greater than 10(5) bacteria/gram of tissue were studied. These patients yielded a variety of microorganisms with P. aeruginosa and Staphylococcus aureus being predominant, followed in incidence by Candida albicans. The resident and transient microflora isolated from each member of the health care team treating the specific individual concerned did not correlate with the causative agent of burn wound sepsis. The most frequent isolate from the staff personnel was Staphylococcus epidermidis followed by Micrococcus species. Though colonization of the thermally injured individual has been reported, these data strongly suggest that colonization is primarily one of an endogenous source rather than that of an exogenous one.