604 Epidemiology and Microbiologic Profile of Pediatric Burn Patients: Eight-years’ Experience in a Tertiary Hospital

Abstract

Abstract Introduction Burn injury is major morbidity and is the third most common cause of mortality among the pediatric population. Methods This study retrospectively analyzed pediatric burn admissions from a tertiary hospital in an 8-year period from 2009–2016. A total of 218 pediatric patients were reviewed for demographics, burn incidence, characteristics, cause of burn and microbiologic profile. Results There were 107(49.08%) Infants, 47 (21.56%)Toddlers, 32 (14.68%) Preschoolers, 17 (7.79%) belonged to school age and 15 (6.88%) were adolescent. Most of the admitted patients were within the city 122 (56%) while 96 (44%) were from other localities outside the city. Scald burn was the most common cause of burn with 160 (73.39%) cases and was highest in the infant age group (49.8%). The mean total body surface area was 10%, the highest being caused by flame burn at 13% TBSA among toddlers and preschoolers having the highest total body surface area involved (12%). The most commonly involved body area is the chest (13.6%). The mean transfer time from injury to the admission of patients coming from within and outside the city was 8.8 and 28 hours respectively. The mean length of hospital stay was 9.08 days. There was also a decrease in mean transfer time and hospital stay from 2009 to 2016. Flame burn accounted for the longest hospital stay at 20.27 days. Microbiologic profile of burn wound cultures showed a predominance of gram-negative rods (90%) with Enterobacter cloacae and Klebsiella pneumonia as common isolates. Culture studies also showed amoxicillin-clavulanic, ampicillin-sulbactam, and cefuroxime have the highest resistance, while most isolates are still susceptible to Amikacin, Ertapenem, Meropenem, and Ciprofloxacin. Conclusions Patients belonging to the school-age group has the highest mean number of hospital days (27.3 days). On review of culture study results from wound tissue samples, Gram-negative rods were the most common and Enterobacter cloacae were the most common isolate. Antibiotics such as Amoxicillin clavulanic, ampicillin-sulbactam, cefuroxime, and ceftazidime had high resistance rates and therefore should not be initially used for patients suspecting of the infected burn wound.