Microbial colonization in a new intensive care burn unit. A prospective cohort study.
Renovation of an existing intensive care burn facility required closure for ten months. An interim eight-bed open intensive care ward (B) was established in a burn convalescence ward. The renovated unit (A) contained nine single-bed intensive care rooms and seven intermediate-level care beds in four rooms. Patients admitted to unit A were treated as a cohort. The first 25 admissions to unit A and the last 25 admissions to ward B meeting the inclusion criteria were compared. Microbial colonization was monitored by a fixed protocol of admission and multiple weekly sputum, wound, stool, and urine cultures. During intensive care, both cohorts exhibited the same incidence of gram-negative wound, sputum, and urine colonization. Occurrence of antibiotic-resistant organisms was the same. No evidence of bacterial cross-contamination was observed between A and B. A continuation of Providencia stuartii and Pseudomonas aeruginosa (type 15) endemics occurred in B. The collected data demonstrate that the A cohort was colonized with new, similar but distinct gram-negative organisms and indicate that cohort separation may be a practical way of eliminating endemic resistant gram-negative organisms from burn units.
D000328:Adult; D000368:Aged; D002053:Burn Units; D002056:Burns / Q000382:microbiology*; D002175:Candida / Q000302:isolation & purification; D004352:Drug Resistance, Microbial; D004754:Enterobacter / Q000302:isolation & purification; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011532:Providencia / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D013211:Staphylococcus aureus / Q000302:isolation & purification