Burns : journal of the International Society for Burn Injuries
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In many burn centers, routine bacteriological swabs are taken from the nose, throat, perineum, and the burn wound on admission, to check for the presence of microorganisms that require specific measures in terms of isolation or initial treatment. According to the Dutch policy of "search and destroy," for example, patients infected by multiresistant bacteria have to be strictly isolated, and patients colonized with β-hemolytic Streptococcus pyogenes must receive antibiotic therapy to prevent failed primary closure or loss of skin grafts. In this respect, the role of bacteria cultured on admission in later infectious complications is investigated. The aim of this study is to assess systematic initial bacteriological surveillance, based on an extensive Dutch data collection. ⋯ Resistant bacteria or microorganisms that impede wound healing and cause major infections are found only in few bacteriological specimens obtained on admission of patients with burn wounds. However, the consequences in terms of isolation and therapy are of great importance, justifying the rationale of a systematic bacteriological surveillance on admission. Patients who have been hospitalized for several days in a hospital abroad and are repatriated show more colonization at admission in our burn center. The microorganisms identified are not only (multi)resistant bacteria, showing that a hospital environment can quickly become a source of contamination. These patients should receive special attention for resistant bacteria. HSA contamination is observed more frequently in younger children. Bacteria present at admission do not seem to play a predominant role in predicting later sepsis.
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Biofuel heaters are a new form of flame heating for indoor and outdoor use. Fuelled by methylated spirits, they are simple structures with few safety features, and can be associated with severe burn. We report five cases of severe burns in adults that occurred when refilling these heaters. ⋯ Biofuel heaters are easily accessible yet there is no Australian Standard to ensure they are safe or perform in the way they were intended. As such, people using them are at undue risk of severe burn, even when following the operating instructions. These products should be removed from the market to prevent further harm and potential mortality.