Pattern and Extent of Hospital Acquired Wound Infections in Burns Patients in A Tertiary Care Hospital (Mayo Hospital Lahore)

Objectives: 1).To determine the extent of hospital acquired wound infections in burns patients and type of organisms involved, in a tertiary care hospital. 2). To see the mode of burns with relation to age, gender and occupation. Study design; Descriptive cross-sectional. Study setting and duration: Burns unit and West surgical wards Mayo hospital Lahore from Jan. 2009 to Nov. 2009. Material and methods: A convenient sample of 106 patients, admitted directly to Mayo hospital within 12-24 hrs of burns, from Jan. to Nov. 2009 was taken as study subjects. Referred cases and those who came after 24 hrs. Of burns were not included. The researcher himself filled a self-structured questionnaire. Most of the information was recorded from history sheet.. Duration between date of admission and culture sent was also recorded. Data was analyzed on SPSS, percentages and proportions were calculated and Chi-square test was applied where cross-tabulation of variables was done. P value < 0.05 was considered significant. Results: All 106 patients had age between 16-75 yrs. Maximum patients (65%) were in age group of 26-50 yrs, the productive age group. Male and female ratio was 59: 47. Majority 71.7% were married & 27.4% were single. Among females 76.1% were housewives & 12.8% students while among males unskilled laborers, skilled, students & businessmen were 23%, 28%, 27% & 25% respectively. Mean surface area with burns for all patients was 41.01% while 41.5% had deep burns and 58.5% had superficial. Regarding mode of burns 86.6% had accidental, 11.5% suicidal and only 2% had homicidal burns. Mean time duration between day of admission and culture sent was 4.64±1.72 days and 79% cultures were sent within 3-5 days of admission. Common organisms isolated as single were staph aureus(15.1%), pseudomonas (14.2), proteus 8.5 and E.coli 6.6% respectively. 51.98% of the cultures showed multiple organisms in different combinations. Most common combination was of pseudomonas & E.coli (14.2%). Pseudomonas, E.coli, proteus and staph aureus were repeated as single or in combination with others as 49%, 28%, 27% & 26% respectively. Statistical test chi-square was applied after cross tabulation between age and sex of the patients and incidence of burns. Both calculations showed statistically non-significant results (p > 0.05). Conclusion: Hospital acquired wound infection among burns patients occurred between 3-5 days of admission. Most common single organism isolated on culture was Staph Aureus and then Pseudomonas. In combination pseudomonas, staph aureus, E.coli, proteus and klebsiella were the most commonly isolated organisms. It was concluded that incidence of burns was more common among productive age group and it was commonly accidental. Key words; Burns patients, hospital acquired wound infections, Mayo Hospital