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

摘要

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 septi-cemic samples, whereas gram-negative bacilli accounted for 67%. Among the gram-positive cocci, Staphylococcus aureus (87.5% methi-cillin resistant Staphylococcus aureus) accounted for the majority (29%) followed by Enterococcus species. In gram-negative bacilli, Pseudo-monas 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.