Staphylococcal infections in the Sofia Burn Centre, Bulgaria.

This study analysed staphylococcal infections in the Sofia Burns Centre in order to estimate their frequency, features and role in burns. For an 8-year period (1987-94) the bacterial aetiology of wound infections and bacteraemia in burned patients was studied. The prevalence of staphylococci in both wound exudation (31.4 per cent) and in blood cultures (60.7 per cent) was established. During the last year of the study there was a significant increase in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) from 19.4 per cent in 1993 to 28.0 per cent in 1994 (P < 0.001). This raised serious therapeutic problems. MRSA were found more frequently in the ICU than in the wards and in wounds and blood cultures compared with other species/strains. MRSA caused infections in 18.8 percent of patients. Over 70 per cent of the MRSA strains were resistant to gentamicin, erythromycin and tetracycline and about one-third to lincomycin, co-trimoxazole, chloramphenicol and ciprofloxacin. All the MRSA strains were sensitive to vancomycin and 71.1 per cent to rifampicin. These findings show the necessity of urgent measures for restriction of the further distribution of MRSA infections in our burns centre.