Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit

  • Emile Coetzee Department of Surgery, Faculty of Medicine, University of Cape Town
  • Heinz Rode Department of Surgery, Faculty of Medicine, University of Cape Town
  • Delawir Kahn Department of Surgery, Faculty of Medicine, University of Cape Town
Keywords: Pseudomonas, Burn wound infection

Abstract

Background. Pseudomonas aeruginosa infection is a major cause of morbidity in burns patients. There is a paucity of publications dealing with this infection in the paediatric population. We describe the incidence, microbiology and impact of P. aeruginosa infection in a dedicated paediatric burns unit. Methods. A retrospective review of patients with clinically significant P. aeruginosa infection between April 2007 and January 2010 in the burns unit at Red Cross War Memorial Children’s Hospital in Cape Town, South Africa, was performed. Results. During the 36-month study period, 2 632 patients were admitted. Of 2 791 bacteriology samples sent for microscopy, culture and sensitivity, 406 (14.5%) were positive for P. aeruginosa. Thirty-four patients had clinically significant P. aeruginosa wound infection, giving an incidence of 1.3%. Three patients had loss of Biobrane or allografts, and 23 cases of skin graft loss occurred in 18 patients. An average of 12 dressing days was needed to obtain negative swabs. All isolates were sensitive to chlorhexidine, whereas 92.5% were resistant to povidone-iodine. Piperacillin-tazobactam was the systemic antimicrobial to which there was most resistance (36.1%), and tobramycin had least resistance (3.3%). Conclusions. The incidence of clinically significant burn wound infection is low in our unit, yet the morbidity due to debridement and re-grafting is significant. We observed very high resistance to topical povidone-iodine. Resistance to systemic antimicrobials is lower than that reported from other burns units.

Author Biographies

Emile Coetzee, Department of Surgery, Faculty of Medicine, University of Cape Town
Consultant Department of Surgery University of Cape Town
Heinz Rode, Department of Surgery, Faculty of Medicine, University of Cape Town
Emmeritus Professor Department of Paediatric Surgery University of Cape Town
Delawir Kahn, Department of Surgery, Faculty of Medicine, University of Cape Town
Head of Division of Surgery Head of deprtment of Surgery Head of Transplant Surgery University of Cape Town
Published
2013-05-03
How to Cite
Coetzee, E., Rode, H., & Kahn, D. (2013). Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit. South African Journal of Surgery, 51(2), 50-53. https://doi.org/10.7196/sajs.1134
Section
General Surgery