Study of Some Clinical, Bacteriological and Immunological Aspects of Patients with Burn Injury

in Hilla 
   
  
  Huda Abdul Wahab J .Balakit   Muhammad Sabri *    Muhammad A.K. Al-Sa adi* 
   
Babylon Health Office, IRAQ.,
 
*Babylon University, College of Medicine, Department of Microbiology  
 
 Medical Journal of Babylon  Volume  4 No 1-2 2007
 
 

  
  Abstract
 
     During the period between November, 2005 and May, 2006 , a total of 78 skin swabs, 48 blood specimens from 78 burn patients, 30 swabs from the burn unit at Al-Hilla General Teaching Hospital, and  12  blood  specimens  from  normal  healthy  subjects(controls)  have  been  bacteriologically  and immunologically studied.   It has been found that Gram negative bacteria are more frequent than Gram positive type in skin, blood and burn unit specimens. Pseudomonas aeruginosa is the most frequent species among the Gram negative bacteria in skin and burn ward. On the other hand, Staph. aureus is the most frequent isolate among Gram positive bacteria.     The level of Boyd index is more than (80) for the dead cases. It  was  observed  that  there  is  no  significant  difference(p>0.05)  between  the  effect  of  silver sulphadiazin(1%) and silver nitrate(0.5%) on bacterial skin isolates. The most affected bacterial species by SSD is the Staph. epidermidis and the least susceptible is Staph. aureus, whereas the most affected  bacterial species by SN is P.aeruginosa and the least affected are Enterobacter and Staph. aureus.     Immunologically, there is a significant decrease(p<0.05) in the mean level of IgG and IgA. IgM is not increased (p>0.05) during bacterial infection of burn victims. Likewise, C3 and C4 complement components  are  not  increased  as  a  mean  level  for  burn  victims  when  compared  to  that  of controls(p>0.05).
 
 
Introduction
 
  urns  are  one  of  the  most common and devastating forms B of trauma. They induce a state of immunosuppression that predisposes burn  patients  to  infectious complications[1].Burninjury  destroys the physical skin barrier that normally prevents the invasion  of  microorganisms  andconsequently,  this  injury  provides novel  sites  for  bacterial  colonization, infection and clinical sepsis[2]. Initially  the  burned  area  is considered  free  of  major  microbial contamination.  However,  Gram positive bacteria in the depth of sweat glands  and  hair  follicles  may  survive the  heat  of  initial  injury  and  unless topical  antimicrobial  agents  are applied, these bacteria heavily colonize the  wounds within the  first 48 hours post-injury.   The  organisms  that  predominate  as causative  agents  of  burn  wound infection in any burn unit change over time  where  Gram  positive  organisms are  initially  prevalent  and  then gradually  superseded  by  Gram negative opportunists[3].     This  study  aims  to  isolate  and identify the aerobic bacteria from burn patients  as  well  as  from  burn  unit, study the effect  of  silver  sulfadiazine and  silver  nitrate  on  bacterial  skin isolates,  clarify  some  clinical parameters  for  burn  patients  and  the Boyd  index  for  the  dead  cases,  and study  some  humoral  immunological factors in burn patients.