Assessment of burn wound infection by swab and biopsy culture: a comparative study

Wound infection is a frequent and severe complication in burn patients accounting for a high number of mortalities. There are some reports comparing swab and biopsy cultures of wounds of various etiologies or chronic wounds. The aim of the study was to evaluate burn wound infection by different bacteriologic methods of surface swab and tissue biopsy culture and see if they can predict the outcome. Aprospective study was conducted in Shahid Motahari Burn Center, Tehran, on patients suffering from burns with more than 20% of TBSAadmitted in 2001-2002. Wound swab and biopsy specimens were collected within the second week. Patients were followed to the point of their discharge or death. Bacterial growth was reported in 100% of swabs, in 89.3% of the biopsies in differential culture media, and in 18.7% of the biopsies in selective culture media. These different cultures had similar pathogen reports. Of the 75 studied patients, 78.7% died. The frequency rates of positive tissue cultures and bacterial load were not different between the dead and those who survived. Bacteriologic methods do not have enough predictive value to assess clinical outcome.