BURN WOUND INFECTION;

SIGNIFICANCE OF RULE OF NINE IN MICROBIAL SURVEILLANCE

Abstract

Background: Burn injuries are common and major health problem throughout
the world. The burn wound represents as a favorable area for opportunistic colonization of
microorganisms with exogenous and endogenous origin. In burns patients infections arise
from multiple sources. Burn wounds become initially colonized and infected with Gram positive
bacteria, mainly Staphylococci, that are superseded during the second week by Gram Negative
bacteria. Objectives: it is a microbial surveillance retrospective study; that aimed to evaluate
the significance of Rule of nine in diagnosis of aerobic bacterial burn wound infection and
carried out in between June 2007 to September 2011 in the Department of Pharmaceutics,
University of Karachi. Study Design: Descriptive retrospective study. Materials: A total of 118
patient irrespective of age, sex, date and time of burn, date and time of hospital admission,
interval between time of burn and hospital admission, degree and percentage (%) of burn and
duration of hospital stay (when specimen collected) were registered for this study. All patients
were divided into two groups (A and B). Results: Out of 58 patients of group A isolation rate per
patient was 1.1 while in group B it becomes 3.0. According to TBSA the isolation rate in group
B rises with rise in TBSA. Most prevalent organism in these patients was found S. aureus(23%)
P.aeruginosa(21%). Conclusions: Burn patients are incubator for variety of aerobic bacteria
and rate of isolation of these organisms increase with rise in TBSA. The wounds of these patient
must required continuous microbial surveillance that may reduce the rate of mortality