Aerobic, anaerobic and fungal burn wound infections.

One hundred and twenty-seven patients were studied prospectively for aerobic, anaerobic and fungal burn wound infections. All cases yielded organisms on culture. A total of 377 isolates were recovered (239 aerobes, 116 anaerobes and 22 fungi). Aerobic bacteria alone were present in 49 patients (38.6%). Anaerobic bacteria alone were present in four patients (3.2%). Candida sp. alone was present in one patient (0.8%). Mixed aerobic and/or anaerobic bacteria and/or fungi were present in 73 patients (57.5%). Fungi were isolated from 21 patients (23.9%) of 88 patients having fungal cultures. The predominant isolates recovered in descending order of frequency were: Pseudomonas aeruginosa, Staphylococcus aureus, Bacteroides sp., Klebsiella sp. and Peptostreptococcus sp. There were 70 patients (55.1%) infected with anaerobic bacteria. The rate of recovery of anaerobes was higher in patients with open wound dressing (72.7%) than in patients with occlusive wound dressings (41.7%), (P < 0.01). Seventeen patients presented with septic shock, 15 of them (88.2%) yielding positive anaerobic cultures. Bacteroides sp. were isolated from 14 patients with septic shock, and were recovered from the four patients who had anaerobic infection alone. These results indicate a significant role of Bacteroides sp. in burn wound sepsis.