A One-year Prospective Evaluation of Infections in a Brazilian Reference Center for Burn Care

Resumo

Abstract:

Introduction: Burned individuals have lost the skin mechanical barrier after burn damage, favoring colonization and blood stream infections. The objective this study is contributed with the knowledge on clinical and microbiological aspects and prognostic evolution of burned patients.

Methods: A one-year prospective study was carried out in a Brazilian reference center for burn care. We were able to enroll 30 patients who accomplished the following requisites. Biopsies were conditioned in 10% buffered formalin recipients and sent to the Pathology Laboratory where they were processed according to standard routines. From Epiderme to Cellular Subcutaneous Tissue all observation fields were examined in order to search and describe present microbiota. McNemar’s test was used to determine whether there was a significant difference in correlation analysis involving tissue culture and histopathology.

Results: During study 228 samples were collected and an identical proportion of 57 samples were obtained between pathology biopsies, tissue culture biopsies, urine and blood cultures. A total of 32 positive results (7.35%) were encountered concerning microbiological analysis. Majority of histopathology punch’s showed microorganisms presence (71,07%) in each collecting period. Gram negative bacilli were found in 61.44% of these samples with gram positive cocci encountered in only 9.63% of these biopsies. Microorganism absence was observed in 27.71% of histopathology samples. The comparison between histopathology and tissue culture was statistically significant (MacNemar Test, p<0.0001), and histopathology proved to be more sensitive.

Conclusions: That the association of diagnostic methods seems to be the best way for the diagnosis of invasive infections in burn patients.

Key Words: burn, microorganisms, infections, diagnosis.