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Bacteriological Analysis and Antibacterial Resistance Pattern in Burn Sepsis: An Observation at a Tertiary Care Hospital in East Delhi

Kumar, Ashwani MBBS, MD*; Kashyap, Bineeta MBBS, MD*; Mishra, Sanjay MBBS, MS†; Agarwal, Vivek MBBS, MS†; Kaur, Iqbal R. MBBS, MD*

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e31822e9a33
Original Articles
Abstract

Background: Burns are one of the most common and devastating forms of trauma because they provide a suitable and more persistent richer source site for bacterial multiplication and infection, mainly because of the larger area involved and longer duration of patient stay in the hospital.

Methods: Blood cultures were analyzed from 80 patients who fulfilled the diagnostic criteria of sepsis admitted between April 2009 and April 2010 to the burns ward of Guru Teg Bahadur Hospital.

Results and Conclusions: Among all the infections that predominated in the burns ward, burn wound infections accounted for 60% followed by septicemia, urinary tract infections, and respiratory track infections. Gram-positive cocci were present in 33% of positive septicemic samples, whereas gram-negative bacilli accounted for 67%. Among the gram-positive cocci, Staphylococcus aureus (87.5% methicillin resistant Staphylococcus aureus) accounted for the majority (29%) followed by Enterococcus species. In gram-negative bacilli, Pseudomonas aeruginosa and Klebsiella species were found in 18% each, whereas Acinetobacter species accounted for 14% of cases followed by Proteus mirabilis in 11% of cases and Enterobacter species and Citrobacter freundii in 1% of cases each. Eighty-nine percent of isolates were resistant to more than 3 antibiotics, and 11% (2 isolates of S. aureus and 1 isolate of P. aeruginosa) were not resistant to more than 3 antibiotics. Infection in the burn patient is a leading cause of morbidity and mortality and continues to be one of the most challenging concerns for the burn team. An institutional policy guiding appropriate selection of antimicrobials for the treatment of infections in burn patients will reduce the burden of illness due to antibiotic-resistant organisms while potentially reducing hospital costs, length of hospital stay, and adverse effects due to these agents.

In Brief

Burns are the most devastating form of trauma as they provide a persistent site for bacterial multiplication. Blood cultures from eighty septicemic burn patients were analyzed. Wound infections accounted for 60% of all the burn infections. Gram positive cocci were present in 33% of positive cultures. Resistant to ≥3 antibiotics was seen in 89% of the isolates. Infection in the burn patients continues to be one of the most challenging concerns for the burn team.

Author Information

From the Departments of *Microbiology, and †Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

Correspondence to: Bineeta Kashyap, MBBS, MD, Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. E-mail: dr_bineetakashyap@yahoo.co.in.

The authors have no funding or conflicts of interest to disclose.

© 2011 Lippincott Williams & Wilkins, Inc.