title: Pseudomonas aeruginosa burn wound infection in a dedicated paediatric burns unit.
abstract: BACKGROUND
  Pseudomonas aeruginosa infection is a major cause of morbidity in burns patients. There is a paucity of publications dealing with this infection in the paediatric population. We describe the incidence, microbiology and impact of P. aeruginosa infection in a dedicated paediatric burns unit.
  
  
  METHODS
  A retrospective review of patients with clinically significant P. aeruginosa infection between April 2007 and January 2010 in the burns unit at Red Cross War Memorial Children's Hospital in Cape Town, South Africa, was performed.
  
  
  RESULTS
  During the 36-month study period, 2 632 patients were admitted. Of 2 791 bacteriology samples sent for microscopy, culture and sensitivity, 406 (14.5%) were positive for P. aeruginosa. Thirty-four patients had clinically significant P. aeruginosa wound infection, giving an incidence of 1.3%. Three patients had loss of Biobrane or allografts, and 23 cases of skin graft loss occurred in 18 patients. An average of 12 dressing days was needed to obtain negative swabs. All isolates were sensitive to chlorhexidine, whereas 92.5% were resistant to povidone-iodine. Piperacillin-tazobactam was the systemic antimicrobial to which there was most resistance (36.1%), and tobramycin had least resistance (3.3%).
  
  
  CONCLUSIONS
  The incidence of clinically significant burn wound infection is low in our unit, yet the morbidity due to debridement and re-grafting is significant. We observed very high resistance to topical povidone-iodine. Resistance to systemic antimicrobials is lower than that reported from other burns units.
authors.affiliation: Department of Surgery, University of Cape Town, South Africa. edt.coetzee@gmail.com
authors.forename: Emile
authors.initials: E
authors.lastname: Coetzee
authors.forename: Heinz
authors.initials: H
authors.lastname: Rode
authors.forename: Delawir
authors.initials: D
authors.lastname: Kahn
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002053:Burn Units; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D014946:Wound Infection / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents