[Clinical significance of the predominant bacterial strains on burn wound during early postburn stage]

Tian-Zeng Li, Lan Luo, Ying-Bin Xu, Xiao-Xin Deng, Shen Liu, Guo-Yin Fan, Shao-Hai Qi
Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns 2003, 19 (2): 71-4

OBJECTIVE: To investigate the clinical significance of the predominant bacterial colonization on burn wound in our department during recent years, so as to help select optimal antibiotics in burn patients with severe infections.

METHODS: This bacterial investigation was carried out in 215 cases of severely burned patients. The bacterial culture and the drug susceptibility test were carried out.

RESULTS: (1) One hundred and twenty-two strains of bacteria were cultured, in which 28 strains (23%) were Staphylococcus with negative coagulase, 27 (22%) S. aureus, 17 (14%) Pseudomonas aeruginosa, 11 (9%) Escherichia coli, 10 (8%) Enterobacter, 9 (7%), enterococci, 3 (2.5%) fungi, and 17 (14.5) other bacteria. (2) The resistance of S. aureus to ampicillin, oxacillin and amoxicillin/clavulanic acid was 81%, 38% and 31%, respectively. 11% and 16% of Pseudomonas aeruginosa resistant to Imipenem and Ceftazidime, respectively. (3) The sensitivity of G + cocci to vancomycin and norvancomycin, Chloramphenicol, Teicoplanin, Trimethoprim/Sulfamethoxaz, Rifampin was 100%, 100%, 100%, 94% and 88% respectively, and the Gram-negative bacilli to Meropenem, Imipenem, Amikacin, Cefepime, Cefoperazone/Sulbactam, Ceftazidime were 91%, 90%, 81%, 78%, 71% and 70%, respectively. Furthermore, the sensitivity of Pseudomonas aeruginosa to Cefoperazone/Sulbactam, Ceftazidime, Tobramycin, Meropenem, Amikacin, Ciprofloxacin, Amikacin, Cefepime were between 82% and 91%. MRSA was very sensitive to both vancomycin and norvancomycin.

CONCLUSION: The results suggested that Staphylococcus with negative coagulase and S. aureus were the predominant bacteria and Pseudomonas aeruginosa ranked second. The resistance of these bacteria to antibiotics was on the increase. Moreover, colonization of enterococcus and fungi on burn wound increased recently, which were scarce before. This implied the importance of rational and correct use of antibiotics during early postburn stage.

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