DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20222843
Published: 2022-10-28

Antimicrobial susceptibility profiles of bacterial isolates from burn wound infections: experience at a tertiary care hospital teaching institution

Bonnie J. Thomas, Balvinder Singh Arora, Savita Arora

Abstract


Background: This study was conducted to know, understand and document the current bacterial isolates and their antimicrobial susceptibility profile in our tertiary healthcare facility. Aim was to isolate, identify and study the current antimicrobial susceptibility profiles of bacterial isolates from patients with burn wound infections admitted in our tertiary care hospital.

Methods: Wound swabs from burn patients admitted in burn ICU and burn wards were collected on day 1, day 3, day 5 and day 10. Samples were processed using standard microbiologic procedure and bacterial isolates that grew on culture was tested for their antimicrobial sensitivity pattern using Kirby Bauer disk diffusion method.

Results: Majority of patients in this study were of the age group of 21 to 30 years (32%). Total body surface area (TBSA) of the study subjects were collected and it was found that the mean TBSA was 39.59±11.6. Total number of bacterial isolates identified during this study was 226 and of those most common was Klebsiella pneumoniae (n=62).  Aminoglycoside resistance were at 61% and among carbapenems, ertapenem showed 90% resistance in Klebsiella pneumoniae isolates. Cefoxitin resistance indicating the presence of MRSA were seen in 31% of Staphylococcus aureus isolates. Acinetobacter showed 100% resistance to ceftazidime.

Conclusions: The results indicate the predominance of drug resistant gram-negative bacterial isolates in burn wounds. Klebsiella pneumoniae came out to be the most common bacterial isolate in our study. Because of increasing resistance and decreasing availability of newer antibiotics, active microbial surveillance and judicious antibiotic usage is the way forward.


Keywords


Antimicrobial susceptibility profiles, Bacterial isolates, Burn wound infections

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References


Miles RS, Amyes SGB. Laboratory control of antimicrobial therapy. In: Colle JG, Fraser AG, Marmion BP, Simmons A, eds, Mackie and McCartney Practical Medical Microbiology. 14th edn. Churchill Livingstone: New York; 1996; 151-177.

Ansermino M, Hemseley C. Intensive care management and control of infection. BMJ. 2004;329:220-3.

Kabboura S. Burn injury: review of pathophysiology and therapeutic modalities in major burns. Ann Burns Fire Disast. 2017;2:97-102.

Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev. 2006;19:403-34.

Norbury W, Herndon D, Tanksley J, Jeschke M, Finnerty C. Infection in Burns. Surg Infect. 2016;17:250-5.

Ramos G. Antibiotic prophylaxis in burn patients: a review of current trends and recommendations for treatment. J Infectiol. 2018;1:1-5.

Ramos G, Cornistein W, Cerino GT, Nacif G. Systemic antimicrobial prophylaxis in burn patients: systematic review. J Hosp Infect. 2017;97:105-14.

Diederen B, Wardle C, Krijnen P, Tuinebreijer W, Breederveld R. Epidemiology of clinically relevant bacterial pathogens in a burn center in the Netherlands between 2005 and 2011. J Burn Care Res. 2015;36:446-53.

Vinitha CT, Tiwari P, Singh S, Rasania S, Khokkar A, Talwar R. Pattern and extent of hospital acquired wound infections in burns patients in a Delhi tertiary Care hospital. Indian J Prev Soc Med. 2011;42:79-81.

Mundhada SG, Waghmare PH, Rathod PG, Ingole KV. Bacterial and fungal profile of burn wound infections in tertiary care center. Indian J Burns. 2015;23:71-5.

Banerjee B. Mahajan’s Methods in biostatistics for medical students and research workers. 9th edn. New Delhi: Jaypee Brothers; 2018:124-125.

CLSI. M100 Performance standard for antimicrobial susceptibility testing. 28th edn. Wayne, PA: Clinical and Laboratory Standards Institute; 2018.

Prabhu K, Rao S, Rao V. Inducible clindamycin resistance in Staphylococcus aureus isolated from clinical samples. J Lab Phys. 2011;3:25-7.

Lewis J, Jorgensen J, Inducible clindamycin resistance in Staphylococci: should clinicians and microbiologists be concerned. Clin Infect Dis. 2005;40:280-5.

Rawat D, Nair D. Extended-spectrum β-lactamases in Gram Negative Bacteria. J Glob Infect Dis. 2010;2:263-74.

Priyadarshini M, Kumar M, Sharma AK, Prashad A, Seema K. Bacteriological profile and antibiogram of burn wound infections from burn patients at RIMS, Ranchi. Int J Med Res Prof. 2018;4:203-6.

Gupta M, Naik AK, Singh SK. Bacteriological profile and antimicrobial resistance patterns of burn wound infections in a tertiary care hospital. Heliyon. 2019;5;1-4.

Jauhari S, Shalabh P, Goyal M, Prakash R, Juyal D. Bacteriological and antimicrobial sensitivity profile of burn wound infections in a tertiary care hospital of Uttarakhand. Int J Curr Res 2020;12:30-6.

Chauhan JR, Khare S, Lal P, Kunhikatta V, Thunga G, Nair S, et al. An appraisal of antibiotic sensitivity pattern and drug utilization in burn patients. Indian J Burns. 2016;24:69-73.

Bhatt P, Rathi K, Hazra S, Sharma A, Shete V. Prevalence of multidrug resistant pseudomonas aeruginosa infection in urn patients at a tertiary care center. Indian J Plast Surg. 2015;23:56-9.

De Macedo JL, Santos JB. Nosocomial infections in a Brazilian Burn Unit. Burns. 2006;32:477-81.

Lunawat A, Sharma R, Kolla V, Patel S. Emerging resistance of higher antimicrobials and growing sensitivity of old antimicrobials against existing infections in burns. Int Surg J. 2015;2:385-91.