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A Prospective Cohort Study

Albert T. McManus, PhD; William F. McManus, MD; Arthur D. Mason, Jr, MD; Annette R. Aitcheson, RN, MS; Basil A. Pruitt, Jr, MD

Arch Surg. 1985;120(2):217-223.

Abstract
• Renovation of an existing intensive care burn facility required closure for ten months. An interim eight-bed open intensive care ward (B) was established in a burn convalescence ward. The renovated unit (A) contained nine single-bed intensive care rooms and seven intermediate-level care beds in four rooms. Patients admitted to unit A were treated as a cohort. The first 25 admissions to unit A and the last 25 admissions to ward B meeting the inclusion criteria were compared. Microbial colonization was monitored by a fixed protocol of admission and multiple weekly sputum, wound, stool, and urine cultures. During intensive care, both cohorts exhibited the same incidence of gram-negative wound, sputum, and urine colonization. Occurrence of antibioticresistant organisms was the same. No evidence of bacterial cross-contamination was observed between A and B. A continuation of Providencia stuartii and Pseudomonas aeruginosa (type 15) endemics occurred in B. The collected data demonstrate that the A cohort was colonized with new, similar but distinct gram-negative organisms and indicate that cohort separation may be a practical way of eliminating endemic resistant gram-negative organisms from burn units.

(Arch Surg 1985;120:217-223)

Author Affiliations
From the US Army Institute of Surgical Research, Fort Sam Houston, Tex.

Footnotes
Accepted for publication Sept 11, 1984.

Read before the Fourth Annual Meeting of the Surgical Infection Society, Montreal, May 1, 1984.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Library, US Army Institute of Surgical Research, Fort Sam Houston, TX 78234.

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