Microbiology of Burn Unit at Yekatit 12 Hospital, Addis Ababa

Negeri, Challa (2005) Microbiology of Burn Unit at Yekatit 12 Hospital, Addis Ababa. Masters thesis, Addis Ababa University.

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Abstract

Burn patients are at risk of acquiring infection because of the loss of skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic procedures. Since specialized burn units were non-existent in Ethiopia before the establishment of one at Yekatit 12 hospital, Addis Ababa, no study was done on burn patients in the country. Hence, to study the microbiology of burn patients admitted at Yekatit 12 hospital, a prospective study was undertaken on 52 patients from March to August 2005. Periodic swabs were taken from the burn patients as well as from the patients’ attendants, attending staffs, and the burn unit environment in order to associate prevailing burn pathogens with endogenous or exogenous sources. The pattern of colonization in the burn wound changed during the hospital stay from a predominance of Gram-positive bacteria (69.8%) at admission to Gram-negative bacteria (68.6%) after the second week. On comparing infected patients (n=38) with non-infected patients (n=14), there was significant difference in age distributions (p=0.035), in burn types (p=0.017), hospital stay (p<0.0001), and total burned surface area (p=0.005) but no significant difference in the frequency of infections by sex (p=0.535). Among the 33 patients without infection on admission, 20(60.6%) developed at least 1 type of nosocomial infection with the most frequent nosocomial infection being burn wound infection (N=20; 60.6%), followed by urinary tract infection (N= 10; 30.3%), bloodstream infection (N=4; 12.1 %) and pneumonia (N=1; 3.0%). Fifty five isolates were recovered from the swabs of infected wounds, of which S. aureus accounted for 40.0% (22/55), and P. aeruginosa for 27.3 %( 15/55). All of the isolates of S. aureus were sensitive to methicillin, clindamycin and vancomycin and were moderately sensitive to chloramphenicol, cephalothin, and augmentin but highly resistant to ampicillin and penicillin G. Thirteen isolates of P. aeruginosa (86.7%) strains were designated multi drug resistant to the commonly used drugs in the burn unit and the country at large. Burn wound infection was the most common infection in the burn unit and S. aureus and P. aeruginosa with high degree of resistance to the commonly used antibiotics in the burn unit were the most commonly isolated organisms from the burn wounds. Since bacterial isolates with identical sensitivity pattern to the clinical isolates were identified from both endogenous sources and exogenous ones, it can be deduced that acquisition of the major burn pathogens was likely multifactorial.

Item Type: Thesis (Masters)
Subjects: Q Science > QR Microbiology
Q Science > QR Microbiology > QR180 Immunology
R Medicine > R Medicine (General)
Divisions: Africana
Depositing User: Emmanuel Ndorimana
Date Deposited: 13 Jul 2018 09:15
Last Modified: 13 Jul 2018 09:15
URI: http://thesisbank.jhia.ac.ke/id/eprint/7404

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