Epidemiological and bacteriological profiles in children with burns

• Published in: Burns Vol. 40; no. 5; pp. 1040 - 1045
• Main Authors: Fekih Hassen, Amjed, Ben Khalifa, Sonia, Daiki, Mayssa
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-08-2014
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacteria; Burn; Burns - epidemiology; Child; Child, Preschool; Children; Cohort Studies; Critical Care; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - microbiology; Drug Resistance, Bacterial; Enterobacter cloacae; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - epidemiology; Female; Gentamicins - therapeutic use; Humans; Infection; Male; Oxacillin - therapeutic use; Piperacillin - therapeutic use; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas Infections - drug therapy; Pseudomonas Infections - epidemiology; Sepsis - drug therapy; Sepsis - epidemiology; Sepsis - microbiology; Staphylococcal Infections - drug therapy; Staphylococcal Infections - epidemiology; Staphylococcus aureus; Wound Infection - drug therapy; Wound Infection - epidemiology; Wound Infection - microbiology; Infection; Burn; Bacteria; Children
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2013.10.020

Abstract Objectives The aim of our study is to determine the most prevalent bacteria responsible for nosocomial infection (NI) in burned children. Materials and methods A prospective analytic study was conducted over a period of 30 months at the Children's Hospital of Tunisia. All burned children were enrolled. Results A total of 185 children were hospitalised during the study period. The mean age was 30 months (interquartile range, IR:18; 48). The gender ratio of the study population was 1.3 (104 males and 81 females). The mean total body surface area burned (TBSA) was 10% (IR:6; 16). The incidence rate of NI was 39.1 NIs per 1000 patient-days and two-thirds of the infections were polymicrobial. The most common isolated micro-organisms were methicillin-susceptible Staphylococcus aureus (MSSA, 57.7%), wild-type Pseudomonas aeruginosa (35.9%) and wild-type Enterobacter cloacae (26.9%). The case fatality rate was 5.9% corresponding to a crude death rate of 1.32 deaths per year. Septic shock with multiple organ failure was the leading cause of death. Conclusion The most common micro-organisms responsible for NI in our series were of the wild-type phenotype. Thus, on suspicion of sepsis, empiric antibiotic treatment combining piperacillin, oxacillin and gentamicin can be proposed until identification of the causative microorganism is available.