Aeromonas hydrophila in burn patients

Burn wound infection with Aeromonas hydrophila appears to be very uncommon. This study reports on nine cases of A. hydrophila in burn patients treated over a 21 month period at the New Somerset Hospital Burn Unit. The average age of the patients was 31 years (range 24-60 years) and the average TBSA was 33% (range 16-51%). All patients had positive wound cultures for A. hydrophila, obtained on admission or shortly thereafter. One patient also had a positive blood culture. Two patients with small partial thickness burns did not receive antibiotic therapy, and made an uneventful recovery with topical therapy alone. The other seven patients developed clinical signs of septicaemia and required parenteral antibiotics, in addition to topical therapy. One patient died of ARDS, but the other eight recovered and were discharged. No patient had evidence of myonecrosis. Small, superficial burns which culture A. hydrophila can be treated by topical therapy alone. Large and/or deep burns, require antibiotic therapy and debridement of all necrotic tissue, particularly when myonecrosis is present. The antibiotics of choice are the aminoglycosides or the quinolones.