Reducing hospital infection rates in the burn unit by adherence to infection control measures: a six-year experience

Aim: To show the effect of infection control measures (ICMs) on nosocomial infections (NIs) in a burn unit. Materials and methods: This study was conducted retrospectively at a 15-bed pediatric and adult burn unit, and 1329 hospitalized patients from 2003 to 2008 were enrolled. Detection and surveillance of NIs was performed by the infection control team (ICT), actively and prospectively, and was patient and laboratory based. Pan-resistant P. aeruginosa strains were seen in the unit in 2003. A periodical education program was applied by the ICT, and some changes were recommended. The hydrotherapy tank was abandoned, antimicrobials were used by the ICT, and new burn wound nursing techniques were applied by the surgeons. Results: During the study period, compliance to ICMs increased. Wet dressing, early debridement, and graft ing were performed. The NI rate decreased from 28.3% to 4.5%, the mortality rates declined from 2.2% to 1.2%, and the mean hospital stay of the patients with NI was reduced from 45.4 to 34.0 days. The numbers of burn wound infection (BWI) and bacteremia were decreased, as were sepsis and mortality attributed to infection. The antibiotic resistance of gram- negative microorganisms declined and pan-resistant P. aeruginosa strains disappeared. Conclusion: NIs can be decreased by ICMs in burn units. Antibiotic usage should be rational. The hydrotherapy tank should not be used if possible. Wet dressing, early debridement, and grafting are the mainstays of the therapy.