NOSOCOMIAL INFECTIONS IN A BURN CARE CENT ER - A ONE-YEAR PROSPECTIVESURVEY

Objectives: To assess nosocomial infections in a burn care centre, to identity patients' infection risk factors at the time of admission and factors of monthly variations of infection incidence. Study design: P rospective survey, from October 1992 to September 1993. Patients and m ethod: The study included 140 patients staying for more than two days in a 22-bed burn unit. Nosocomial infection criteria were derived from the 1988 CDC critera. Incidence rates of infection were calculated. I nfected and noninfected patients were compared. Each monthly infection incidence was compared with six unit activity indicators. Results: Fi fty-six patients developed 132 infections. The overall incidence was 9 4%. Incidence density was 25 infections per 1,000 days of care. The di stribution of infected sites was: skin (30%), intravascular catheters (25%), blood (22%), urinary tract (18%), respiratory tract (5%). The m ost frequent pathogens were Pseudomonas sp (49%), Staphylococcus sp (1 8%), Escherichia coli (18%), and Streptococcus faecalis (10%). They we re characterized by a good antibiotic sensitivity. Each common bum sev erity index was predictive of nosocomial infections. Facial, perineal and respiratory lesions were also linked to infection. There was a pos itive correlation between the peak of nosocomial infections in the uni t during a month and the peak of activity during the foregoing one. Co nclusion: Incidence rates of infection were high, as 40% of the popula tion was concerned. Choosing reliable infection criteria was the most difficult problem to solve.