Seventy-nine (8.4%) patients during June 1992-May 1996 (Group-1) and 68 (7.2%) patients from June 1996 to May 2000 (Group-2) who developed septicaemia at the
burns unit of Al-Babtain Centre for Plastic Surgery and
Burns, Kuwait, were retrospectively studied and compared. The mean age of 26 years, male predominance, flame
burns as main aetiology and mean
burn percentage of >or=40% was observed in both the groups. Both groups revealed extensive flame
burn, inhalation injury, intubation and difficult
resuscitation as the risk factors. The proportion of satisfactory
resuscitation increased significantly (P<0.001) in Group-2. The septicaemia commonly occurred within 2 weeks postburn but the number of episodes during 5 days postburn was less in Group-2. The surface
wound was found to be the likely source of entry of the organisms into the blood stream in both the groups. The gram positive organisms were dominant aetiologic factor in both groups but an increase frequency of Acnetobacter was found in Group-2. The proportion of MRSE and Pseudomonas septicaemia was significantly higher (P<0.01) in the Group-1. The rate of survivors, in both the groups was higher among operated patients but it was significantly higher (P<0.001) in the Group-1. A mortality rate 20.6% in Group-2 decreased against Group-1, which can be attributed to better
resuscitation, nutritional care, early detection of septicaemia, appropriate
antibiotics and early
wound excision and
skin grafting. MOF was the cause of death of 60.9% in Group-1 and 85.7% in Group-2. There was no role of prophylactic
antibiotic in
burn patients in the incidence of septicaemia and mortality.