Skin flora of patients in Thailand

Background: Studies taken from different hospitalized patient populations, environments, and geographic regions reveal differences in the numbers and species of organisms colonizing the skin. Our aim was to determine the types and amounts of skin flora, and examine the factors associated with variations in microbial skin flora in patients in Thailand. Method: We studied 350 outpatients and 500 inpatients at Siriraj Hospital in Bangkok, Thailand. The skin at the forearm and the sternum of each patient was cultured by contact plate technique. Results: The number of skin flora colony-forming units (CFUs) were correlated to the site of sampling. There was a significant correlation of CFUs between samples from the forearm and the sternum in patients who were hospitalized (r = 0.6; P < .001) and in outpatients (r = 0.5; P < .001). The numbers of micro-organisms on the sternum was significantly greater than the number cultured from the forearm for all patients. Inpatients had significantly more organisms on the the forearm and sternum compared with outpatients. High counts (CFUs > 600) were found more frequently in patients who were hospitalized; had chronic obstructive pulmonary disease, diabetes mellitus, or autoimmune diseases; and were undergoing operation and receiving antibiotics. Acinetobacter spp and methicillin-resistant Staphyloccoccus aureus were found more frequently in patients who were hospitalized. Conclusion: Skin flora of patients in tertiary care hospitals in Thailand has higher CFUs, and A baumannii is prevalent, especially in patients who are hospitalized. (Am J Infect Control 2003;31:80-4.)