Antimicrobial resistance and metallo β lactamase in gram-negative isolates of hospital-acquired burn wound infections

Abstract

Introduction: In India, accidental contact with direct flame is the most common cause of burns. More than 90% of burn wounds are II and III degree, though surface area involved is less than 40%. Burn patients are at high risk of infection as a result of the nature of injury, immunocompromising effect of burn, prolonged hospital stay, and invasive procedures. Multidrug-resistant bacterial infection is major cause of mortality in these patients. Aim: This study was undertaken to determine the prevalence of metallo b lactamase (MBL) producing gram-negative isolates in burn wound infections, so as to guide the clinicians to select appropriate antimicrobial therapy and prevent the spread of MBL in gram-negative bacteria. Materials and Methods: Pus sample collected from 147 patients admitted to the burn unit, of government general hospital Karimnagar were processed by standard bacteriological methods. Imipenem-resistant isolates were screened for MBL production by combined disk test. Results: Study revealed that 40% Proteus and 19.05% Pseudomonas produce MBL and MBL producers are 100% resistant to imipenem and ceftazidime. Conclusion: Patients of burn with MBL-positive P. aeruginosa infections will have higher morbidity and mortality. Piperacillin/tazobactam seems to be effective options for the treatment of MBL-positive P. aeruginosa infections.