Rapid Detection of Staphylococcus Aureus in Burn Patients

Burn patients have lost their primary barrier to microorganism invasion and therefore are
continually and chronically exposed to pathogens. Ninety-seven percent of patients with >20%
total body surface area (TBSA) burns develop septicemia; predominantly involving gram
positive cocci including MRSA and methicillin sensitive Staphylococcus aureus. Blood culture
(BC) is the traditional detection method for septicemia. However, antibiotics and inadequate
sample volumes can impair detection by BC and results can take 3-4 days.

Polymerase chain reaction (PCR) represents a potential adjunct to BC. Pathogens are detected
in a growth-independent manner by targeting their genetic make-up. Quantitative determining
of pathogen DNA using PCR could aid in determining antimicrobial drug therapy efficacy by
providing results on the same testing day as opposed to 3-4 days with BC. PCR may also detect
persistent infections during antimicrobial therapy when culture samples are inhibited.

The aims of this study are:(1)to correlate quantitative PCR results with that of the BC; (2)
to test the clinical application of PCR results with clinical outcomes of treatment of
presumptive diagnosis of staphylococcal sepsis.

Inclusion Criteria:

- 20% or > TBSA burns at hospital admission

- will require BC during hospital stay

- Patient/surrogate able to sign consent

Exclusion Criteria:

- allergic to nafcillin, cefazolin, vancomycin, linezolid, and/or daptomycin

- on antibiotic(s) prior to first BC