Professional Med J 2014;21(5): 869-873 www.theprofessional.com BURN WOUND INFECTION 869 Article Citation: Naqvi SZA, Naqvi SMA, Usman M, Naqvi SBS. Burn wound infection; sig- nifcance of rule of nine in microbial surveillance. Professional Med J 2014;21(5):869-873. The Professional Medical Journal www.theprofesional.com BURN WOUND INFECTION; SIGNIFICANCE OF RULE OF NINE IN MICROBIAL SURVEILLANCE Dr. Syed Zulfqar Ali Naqvi 1 , Dr. S. M. Abbas Naqvi 2 , Dr. Muhammad Usman 3 , Professor Dr Syed Baqar Shyum Naqvi 4 ORIGINAL PROF-2593 ABSTRACT… Background: Burn injuries are common and major health problem throughout the world. The burn wound represents as a favorable area for opportunistic colonization of microorganisms with exogenous and endogenous origin. In burns patients infections arise from multiple sources. Burn wounds become initially colonized and infected with Gram positive bacteria, mainly Staphylococci, that are superseded during the second week by Gram Negative bacteria. Objectives: it is a microbial surveillance retrospective study; that aimed to evaluate the signifcance of Rule of nine in diagnosis of aerobic bacterial burn wound infection and carried out in between June 2007 to September 2011 in the Department of Pharmaceutics, University of Karachi. Study Design: Descriptive retrospective study. Materials: A total of 118 patient irrespective of age, sex, date and time of burn, date and time of hospital admission, interval between time of burn and hospital admission, degree and percentage (%) of burn and duration of hospital stay (when specimen collected) were registered for this study. All patients were divided into two groups (A and B). Results: Out of 58 patients of group A isolation rate per patient was 1.1 while in group B it becomes 3.0. According to TBSA the isolation rate in group B rises with rise in TBSA. Most prevalent organism in these patients was found S. aureus(23%) P.aeruginosa(21%). Conclusions: Burn patients are incubator for variety of aerobic bacteria and rate of isolation of these organisms increase with rise in TBSA. The wounds of these patient must required continuous microbial surveillance that may reduce the rate of mortality Key words: Burns, TBSA, Infection, Rule of nine 1. Associate Professor Department of Pathology Independent Medical College Faisalabad 2. Associate professor Department of Pathology Nishtar Medical College Multan 3. Assistant Professor Department of Pathology Independent Medical College Faisalabad 4. Department of pharmaceutics University of Karachi Correspondence Address: Dr. Syed Zulfqar Ali Naqvi Associate Professor of Pathology Independent Medical College Faisalabad drwa65@yahoo.com Article received on: 18/07/2014 Accepted for publication: 15/08/2014 Received after proof reading: 16/10/2014 INTRODUCTION Burn injuries are common and major health problem throughout the world. Burn is one of the major types of injury and it is estimated that 1% peoples in the world affected by serious burn injury during their life. it is also estimated that burn injury accounts 1% of total disease those comes in hospital for treatment, unfortunately majority (>95%)of burn injuries occurs in developing countries and resulting in signifcant morbidity, disability, and mortality 1-5 . After initial period of shock, Infection of burn injuries is common complication, and is a major cause of death in burn patients. It is estimated that more than 70% deaths occurs in burn patients due to infection and these patients remain at risk of death until unless burn wound does not heal completely 6 . Tissue destruction in burns is diagnosed by two different ways together. 1. The total burn surface area is measured in percentage by rule of nine or by Lund and Browder estimation protocol. 2. The total skin and tissue loss in depth of burn wound measured by clinical experience. This injury is characterized by coagulation necrosis of the cells, thrombosis of the blood vessels, accumulation of fuid and cellular infltrate. Cellular damage occurs as protein is denatured by rising temperature while accumulation of fuid resulted by release of series of chemical mediators 4,7 . Signifcant burn injuries induce a state of Immunosuppression including Suppression of non specifc immunity as well as Suppression of specifc immunity 8 . Burn wound sepsis is an imbalance in the