An Evaluation of Burn Infections Caused by Multidrug Resistant A.baumannii and the Treatment Approach

Abstract

Background: If not treated properly, A.baumannii infections in burn patients may cause delays in wound healing, graft losses, or even development of sepsis that may lead to death in cases where the bacteria enters the systemic circulation. In this study, our aim is to present the treatment options and their results in patients where burn infections due to multidrug resistant (MDR) A.baumannii have been diagnosed.

Methods: For the purpose of the study, 27 burn patients treated in our burn centre between June 2008 and January 2011, whose wound cultures revealed A.baumannii growth, were evaluated retrospectively. 16 among these patients (59.2%) were male, whereas 11 (40.8%) were female. The mean age of the patients was 32 (1 - 64) years and the total body surface area (TBSA) burned was 10 - 65% (33.2%). The patients were evaluated in terms of compliance to the infection control and prevention standards, local wound treatment, systemic antibiotherapy according to the results of the antimicrobial sensitivity test, early surgical debridement and grafting.

Results: According to the results of the antimicrobial sensitivity test, the acinetobacteria were only sensitive to colistin. Full response to the treatment was achieved in all the patients where there was growth in the tissue cultures although no growth in the blood cultures was observed. Among the 5 patients whose blood cultures showed bacterial growth, 2 responded fully to the treatment whereas the other 3 patients (11.1%) died of sepsis. The graft donor areas, grafts, and the superficial burn areas in all the patients healed without problem at the end of the treatment.

Conclusion: In the light of the information we obtained from our study, we believe that an early diagnosis of the wound infection, administration of the appropriate topical and systemic antimicrobial treatments, early surgical debridement and grafting is effective in controlling the infection in the management of the burn wounds infected with MDR A.baumannii.




doi:10.4021/jcs105e