Microbial colonization in a new intensive care burn unit. A prospective cohort study
A. T. McManus, W. F. McManus, A. D. Mason Jr, A. R. Aitcheson and B. A. Pruitt Jr
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 antibiotic-resistant 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.
