Analysis of bacteriuria in patients with burns.

A detailed analysis of bacteriuria in 148 aged patients with burns was made for a period of 2 years (1991-92), in order to determine the incidence of the urine infections they sustained, the sources and mechanisms of the infections and the impact on the course and outcome of the primary disease. Urine infection was found in 7.6 per cent (46 patients) of all patients treated for burns during the study period; 39.1 per cent were community acquired uroinfection (CAU) and 60.9 per cent were hospital acquired (HAU). In addition there were eight patients with bacteriuria, secondary to a generalized bacterial infection (GBI), and 11 with candiduria associated with massive antibacterial therapy. Leading causes of CAU were the common uropathogens: E. coli, Citrobacter and Proteus sp.; those of HAU were multiresistant hospital strains, characteristic of the Burns Clinic: Pseud. aeruginosa, Klebsiella sp., Acinetobacter sp. and Serratia sp. This study confirmed the role of transurethral catheterizations as factors associated with the development or exacerbation of chronic uroinfections, which increased the chances of non-survival, especially in aged people with concomitant chronic urological, nephrological or other underlying diseases. The causes of death in 20 patients with HAU, CAU, GBI and candiduria were analysed. The need for strict monitoring of burned patients at risk for uroinfection development and the need to take urgent preventive measures is emphasized.