Epidemiological and bacteriological profiles in children with burns.

Abstract

The aim of our study is to determine the most prevalent bacteria responsible for nosocomial infection (NI) in burned children. A prospective analytic study was conducted over a period of 30 months at the Children's Hospital of Tunisia. All burned children were enrolled. 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. 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.