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Burns. 2003 May;29(3):229-33.
Colonization of burn wounds in Ain Shams University Burn Unit.

Nasser S, Mabrouk A, Maher A.

Burn Unit, Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Ain Shams University Hospital, 6, Mahmoud Sadek Street, Golf Zone, Heliopolis, Cairo 11341, Egypt.

A prospective study was carried out on 70 burned patients admitted to the Burn Unit, Ain Shams University Hospital, Cairo, with the aim to verify the pattern of microbial colonization of burn wounds. Throughout the study period starting from 1 June 1999 till 31 May 2001, 281 sampling procedures (surface swabs) were performed from the burn wounds. A total of 301 microbial isolates were grown in cultures. Eight different species of bacteria, and only one species of Candida (C. albicans) were detected. There was no incidence of recovery of anaerobic microorganisms. Our results revealed that the most frequent isolate was Pseudomonas aeruginosa (21.6%), followed by Klebsiella pneumoniae (15.2%), then Escherichia coli (13.6%), Staphylococcus aureus (13.2%), coagulase-negative Staphylococci (11.6%), Streptococcus pyogenes (8.3%), Enterobacter species (6.6%), and lastly Streptococcus faecalis and Candida albicans (5.9 and 3.6%, respectively). Studying the time-related changes in burn wound microbial colonization showed an initial predominance of gram-positive cocci upon admission (70.7%) over gram-negative bacilli (27.6%). During the first 5 days, gram-negative bacilli started to predominate (55.7%) over gram-positive cocci (40.3%). Burn wound sampling performed starting from the sixth day onwards, revealed further prevalence of gram-negative bacilli (72.7%) over gram-positive cocci (22.7%). As for Candida albicans, there was a gradual increase in the frequency of its recovery as time elapsed from admission. It is crucial for every burn institution to determine the specific pattern of burn wound microbial colonization, the time-related changes in the dominant flora, and the antimicrobial sensitivity profiles. This would enable early treatment of imminent septic episodes with proper empirical systemic antibiotics, without waiting for culture results, thus improving the overall infection-related morbidity and mortality.

PMID:_12706615 Zentralbl Bakteriol [B]. 1979 Jun;168(5-6):493-506.
[Examinations on the behaviour of grampositive and gramnegative bacteria on aluminium foil (author's transl)]

[Article in German]

Dickgiesser N, Ludwig C.

The survival times of Staph. aureus, Strept. faecalis, E. coli, Klebs. pneumoniae, Ser. marcescens and P. aeruginosa were found out on aluminium foil. It was examined whether there exists a dependence on the initial colony count and in mixed cultures a mutual influence of the several species of bacteria. The longest survival times were found among the grampositive cocci. Ser. marcescens and Klebs. pneumoniae could no more be indicated after 19 days in case of initial colony count of log 7.0/cm2; E. coli could no more be shown after 14 days. P. aeruginosa had the shortest survival time. The dependence on the initial colony count was ascertained in 3 different concentrations of bacteria. The highest concentrations showed the smallest reduction of cocci and the longest survival times of Enterobacteriaceae respectively. The middle and lowest initial colony counts showed quicker reduction or shorter survival times. Ser. marcescens was more resistant to drying than Klebs. pneumoniae. The quickest dying rates showed P. aeruginosa without any dependence on initial colony count. In mixed cultures with Staph. aureus or Strept. faecalis survival times of Enterobacteriaceae were longer; the same result gave Klebs. pneumoniae in culture together with Ser. marcescens. The following explanation might be possible: because of the drying resistance of grampositive cocci the total bacteria number in these mixed cultures after several days is higher than in monocultures of E. coli, Klebs. pneumoniae or Ser. marcescens. This protects the Enterobacteriaceae against external influences for a longer time. Therefore it is understandable that the effect increases with the length of duration. The same interpretation could apply to the mixed cultures of Klebs. pneumoniae/Ser. marcescens.

PMID:_116442 Br J Surg. 1979 Oct;66(10):727-32.
Fine needle catheter jejunostomy--an assessment of a new method of nutritional support after major gastrointestinal surgery.

Yeung CK, Young GA, Hackett AF, Hill GL.

The results of our experience with the technique of fine needle catheter jejunostomy and early postoperative feeding through the catheter over a 12-month period are presented. Of the 43 patiening with an elemental diet without complications, 3 (7 per cent) were not fed for different reasons and 13 (30 per cent) developed complications that led to temporary or permanent cessation of the feeding. One patient in this group died of inhalation pneumonia. The voluntary food intake of 12 of the patients who were fed by jejunostomy after major colorectal surgery was assessed daily for 2 weeks after operation and compared with that of 12 control patients who did not have nutritional support. No significant difference in voluntary food intake was found between the two groups. The changes in body composition and plasma proteins and the clinical outcome of 20 of the patients fed by jejunostomy after major colorectal surgery were also compared with those of 20 matched controls. Body weight and lean body mass (as assessed by total body potassium and arm muscle circumference) and plasma prealbumin fell significantly in the control patients but not in those fed by jejunostomy. However, plasma transferrin decreased in both groups and there was no significant difference in clinical outcome in terms of complication rate or duration of postoperative hospital stay. The study would suggest that this technique of jejunostomy feeding should be reserved for selected cases where it may prove to be of real value, rather than being used routinely.

PMID:_116701 J Gen Virol. 1979 Aug;44(2):479-91.
Pneumoviruses: the cell surface of lytically and persistently infected cells.

Parry JE, Shirodaria PV, Pringle CR.

Human embryonic lung (MRC-5), feline embryo (FEA), mink lung (Mv1Lu) and monkey kidney (BSC-1) cells infected by respiratory syncytial virus showed characteristic morphological changes when viewed by scanning electron microscopy. The surfaces of respiratory syncytial virus-infected cells developed a profusion of slender filaments after 48 h incubation at 31 degrees C. Similar changes in surface morphology were observed in BSC-1 cells infected by murine pneumonia virus. Filament production therefore appears to be a common property of pneumo-viruses. Filaments were not observed in cells infected with either syncytial and non-syncytial herpes simplex virus, the cytocidal vesicular stomatitis and Batai (Bunyaviridae) viruses, or the focus-inducing rabbit fibroma virus. Filament production was not observed in cells infected with ts mutants of respiratory syncytial (RS) virus during incubation at the restrictive temperature, or in a persistently infected culture of BSC-1 cells at 37 degrees C. The persistently infected cells (the RS ts 1/BSC-1 line) had some of the characteristics of cells transformed by oncogenic viruses, namely ability to overlap adjacent cells and agglutination by a low concentration of concanavalin A. The pseudo-transformed phenotype was temperature-dependent, however, and suppressed by raising the temperature of incubation to 39 degrees C. The presence of virus antigen at the cell surface was similarly temperature-dependent in these cells, diminished at high temperature (39 degrees C) and enhanced at low temperature (31 degrees C), suggesting that the changes in the host cell were the result of insertion of virus protein into the cell membrane. Evidently, persistent infection by a cytoplasmic virus can produce alterations in the host cell usually associated with transformation by nuclear viruses.

PMID:_118236 Burns. 2003 May;29(3):235-8.
Bacteriology of burns at the Queen Elizabeth Central Hospital, Blantyre, Malawi.

Komolafe OO, James J, Kalongolera L, Makoka M.

Department of Microbiology, College of Medicine, Private Bag 360, Chichiri, Blantyre 3, Malawi.

A retrospective study to determine the bacterial profile and antibiotic susceptibility pattern of burn isolates at the Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi was undertaken. While a total of 1825 burn patients were admitted to the hospital over a 6-year period (January 1994 to December 1999) only 317 (17.4%) specimens selected from as many patients were processed. One hundred and seventy (170/53.6%) specimens yielded single while the rest (147/46.4%) had multiple isolates giving a total of 535 bacterial isolates. Of this number, 236 (44.1%) were Gram-negatives and 299 (55.9%), Gram-positives. Among the Gram-negatives, Pseudomonas aeruginosa, Proteus mirabilis, Coliforms/Escherichia coli and Klebsiella pneumoniae were the most common accounting for 94.1% while in the Gram-positive group, staphylococcal and streptococcal spp. predominated (100%). However, the three most common isolates were Staphylococcus aureus (37.6%), P. aeruginosa (22.4%) and beta-haemolytic streptococci (13.6%). While S. aureus and beta-haemolytic streptococci were most susceptible to penicillin (33.3 and 64.4% susceptibility, respectively), gentamycin appeared most effective against P. aeruginosa (53.3%). A general broad-spectrum resistance to panels of antibiotics used in the study was however observed among the bacterial isolates. From these results, S. aureus, P. aeruginosa, streptococcal spp., P. mirabilis, Coliforms and K. pneumoniae representing 96.4% of all isolates were the most common in the Burns Unit.

PMID:_12706616

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