Abstract

Introduction: Burn wound infections are among the most serious complications following thermal injuries and contribute significantly to morbidity and mortality. Approximately 75% of deaths following burns are attributed to infection. The increasing prevalence of multidrug-resistant (MDR) organisms, such as Extended-Spectrum Beta-Lactamase (ESBL)-producing Gram-negative bacilli and Methicillin-Resistant Staphylococcus aureus (MRSA) poses a major therapeutic challenge. This highlights the need for periodic surveillance of microbial profiles and antibiotic susceptibility patterns in burn units. Aim: To determine the bacteriological profile and antimicrobial resistance patterns of bacterial isolates from burn wound patients admitted to the burns ward over one year (September 2018 – October 2019), and to compare the findings with data from a similar study conducted 18 years ago in the same institution. Methods: Wound swabs were collected aseptically from burn patients admitted to the burns ward of King George Hospital, Visakhapatnam, and processed at the Department of Microbiology, Andhra Medical College. Bacterial identification was done using standard microbiological techniques. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method and interpreted as per CLSI guidelines. ESBL, MBL, and MRSA were identified using standard phenotypic tests. Results: Of the 264 samples processed, 238 bacterial isolates were obtained. Pseudomonas aeruginosa (4.6%) and Enterococcus faecalis (1.6%) were among the isolated organisms. Among the 238 isolates, 163 (68%) were identified as multidrug-resistant. Notably, 31 isolates (13%) were Methicillin-Resistant Staphylococci, 81 (34%) were ESBL producers, and 51 (21%) were MBL producers. Conclusion: The study reveals a high prevalence of multidrug-resistant organisms in burn wounds, underscoring the urgent need for regular microbiological surveillance and rational antibiotic use. The evolving resistance trends over 18 years necessitate updated antibiotic stewardship protocols to optimize treatment outcomes and reduce burn-related morbidity and mortality.

• 1.   Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev. 2006;19(2):403–34.
• 2.   Collaborators GB. of DS 2013. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(9995):743–800.
• 3.   Rafla K, Tredget EE. Infection control in the burn unit. Burns. 2011.
• 4.   Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 2014.
• 5.   Kumar V, Bhatnagar SK, Singh AK, Kumar S, Mishra RK. Burn Wound Infection: A study of 50 cases with special reference to antibiotic resistance. Indian J Bio Res. 2001;46:66–9.
• 6.   Mehta M, Dutta P, Gupta V. Bacterial isolates from burn wound infections and their antibiograms: A eight-year study. Indian J Plast Surg. 2007;.
• 7.   Pujji OJS, Nakarmi KK, Shrestha B, Rai SM, Jeffery SLA. The Bacteriological Profile of Burn Wound Infections at a Tertiary Burns Center in Nepal. J Burn Care Res. 2019;
• 8.   Sadeghi-Bazargani H, Mohammadi R. Epidemiology of burns in Iran during the last decade (2000-2010): Review of literature and methodological considerations. Burns. 2012.
• 9.   Saaiq M, Ahmad S, Zaib MS. Burn wound infections and antibiotic susceptibility patterns at Pakistan Institute of Medical Sciences, Islamabad, Pakistan. World J Plast Surg. 2015;4(1):9.
• 10.   Chaudhary NA, Munawar MD, Khan MT, Rehan K, Sadiq A, Tameez-ud-din A, et al. Epidemiology, Bacteriological Profile, and Antibiotic Sensitivity Pattern of Burn Wounds in the Burn Unit of a Tertiary Care Hospital. Cureus. 2019;
• 11.   Agnihotri N, Gupta V, Joshi RM. Aerobic bacterial isolates from burn wound infections and their antibiograms—a five-year study. Burn Agnihotri N, Gupta V, Joshi RM Aerob Bact Isol from Burn wound Infect their antibiograms—a five-year study Burn 2004;30(3)241–3. 2004;30(3):241–3.
• 12.   Sharma M, Taneja N. Burns, antimicrobial resistance & infection control. Indian Journal of Medical Research. 2007.
• 13.   Kaur H, Bhat J, Anvikar AR, Rao S, Gadge V. Bacterial profile of blood and burn wound infections in burn patients. Burns. 2006;34: 89–95.
• 14.   Macedo JLS de, Santos JB. Bacterial and fungal colonization of burn wounds. Mem Inst Oswaldo Cruz. 2005;100(5):535–9.
• 15.   Abbas Ha, El-Masry Em, Shaker Gh, Mohsen I. Bacterial Etiology and Antimicrobial Resistance Of Burn Wound Infections In A Burn Unit In Hehia General Hospital In EGYPT. Int J Biol Pharm Res. 2013;4(12):1251–5.
• 16.   Ramakrishnan MK, Sankar J, Venkatraman J, Ramesh J. Infections in burn patients— experience in a tertiary care hospital. Burns. 2006;32(5):594–6.
• 17.   Kaushik R, Kumar S, Sharma R, Lal P. Bacteriology of burn wounds—the first three years in a new burn unit at the Medical College Chandigarh. Burns. 2001;27(6):595–7.
• 18.   Dhar S, Saraf R, Singh K, Raina B. Microbiological profile of chronic burn wounds among patients admitted in burn unit. JK Sci. 2007;9(4):182–5.
• 19.   Gupta AK, Uppal S, Garg R, Gupta A, Pal R. A clinico-epidemiologic study of 892 patients with burn injuries at a tertiary care hospital in Punjab, India. J emergencies, trauma Shock. 2011;4(1):7.
• 20.   Lari ARR, Alaghehbandan R, Akhlaghi L. Burn wound infections and antimicrobial resistance in Tehran, Iran: an increasing problem. Ann Burns Fire Disasters. 2005;18(2):68.
• 21.   Ekrami A, Kalantar E. Bacterial infections in burn patients at a burn hospital in Iran. Indian J Med Res. 2007;126(6):541.
• 22.   Rajput A, Singh KP, Kumar V, Sexena R, Singh RK. Antibacterial resistance pattern of aerobic bacteria isolates from burn patients in tertiary care hospital. Biomed Res. 2008;19(1):1–4.
• 23.   Bairy I, Shivananda PG. Aerobic bacterial flora of burn wound infection. Indian J Surg. 1997;59:215–8.
• 24.   Nagesha CN, Shenoy KJ, Chandrashekar MR. Study of burn sepsis with special reference to Pseudomonas aeruginosa. J Indian Med Assoc. 1996;94(6):230–3.
• 25.   Nagoba BS, Deshmukh SR, Wadher BJ, Pathan AB. Bacteriological analysis of burn sepsis. Indian J Med Sci. 1999;53(5):216–9.
• 26.   Song W, Lee KM, Kang HJ, Shin DH, Kim DK. Microbiologic aspects of predominant bacteria isolated from the burn patients in Korea. Burns. 2001;27(2):136–9.
• 27.   Oncul O, Ulkur E, Acar A, Turhan V, Yeniz E, Karacaer Z, et al. Prospective analysis of nosocomial infections in a burn care unit, Turkey. Indian J Med Res. 2009;130(6):758–64.
• 28.   Guggenheim M, Zbinden R, Handschin AE, Gohritz A, Altintas MA, Giovanoli P. Changes in bacterial isolates from burn wounds and their antibiograms: a 20-year study (1986– 2005). Burns. 2009;35(4):553–60.
• 29.   Imran M, Faheem M, Aslam V, Hakeem A, Shah A. Wound infections and culture sensitivity pattern in pediatric burn patients. J Postgrad Med Inst. 2011;23(4).
• 30.   Kehinde AO. Pattern of bacterial pathogens in Burn wound infection in Ibadan, Nigeria. Ann Burns Fire Disasters. 2004;(1):12–5.

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