Aetiology, factors associated with injury severity, and bacterial susceptibility patterns among burn patients in six selected hospitals in Uganda.

backgroundGlobally, burn injury is of public health concern; it is a significant health problem in both children and older adult populations. In Africa and especially in Uganda, burn injuries remain a major cause of prolonged hospital stays, disability, disfigurement and death. A lot of factors may be associated with the injury severity of burn wounds. Bacterial microorganisms take short hours to invade the burn wound and can be identified in the burn wounds less than 24 hours old. When a patient is alive after 3 days following a burn, then the commonest cause of death is infection. Bacterial infection is still the serious complication that might compromise with the patient's life after the early phase of the management, and the bacterial pathogens isolated from these wounds might still be resistant to the most common used antibiotics in our setting.

objectivesThe aim of this study was to determine the most common etiology, the factors associated with injury severity, and the bacterial susceptibility patterns of burn patients in six selected hospitals in Uganda.

methodsThis cross-sectional study was conducted in the departments of surgery at the six selected hospitals from April to July 2022.

resultsAround 76 patients admitted to those hospitals with burns during our study period were included. Those who were very severe without caretakers eligible to consent for them were excluded. The average age was 17.7 years. There were slightly more males with a male-to-female ratio of 1.05. The majority were from the rural areas accounting for 76.3%. The common etiology was thermal, accounting for 80.8%, dominated by scalds (60.5%). Patients with burn wounds at the sites mandating admission were 22 times more likely to have a severe injury. The most common organism isolated was staphylococcus aureus accounting for 45.2%, followed by Pseudomonas, accounting for 15.5%, and they % were resistant to most of the antibiotics used in our study. Despite that identified bacteria were resistant to most of antibiotics, a good number of them were sensitive to imipenem, amikacin, ciprofloxacin, and cloxacillin.

conclusionsImplementation of burn infection control policies is needed. There is a need to include sites mandating admission in the parameters of the ABSI score. Based on microorganisms isolated, empirical treatment with ciprofloxacin or cloxacillin should be considered.