Bacteriologic Profile of Burn Wounds at a Tertiary Government Hospital in the Philippines-UP-PGH ATR Burn Center.

Abstract

Wound infection is a major cause of morbidity and mortality among burn patients. Recent changes in the epidemiology of burn wound infections were observed due to the steady rise of drug-resistant bacteria. The objective of this study is to determine the most common burn wound pathogens isolated among patients admitted at the UP-PGH ATR Burn Center, describe their respective susceptibility patterns, and calculate incidence rates of burn wound colonization, local, and invasive infection. Patients admitted at the UP-PGH Burn Center from March 2015 to February 2016 with tissue culture studies were monitored for development of wound infection; patient charts, tissue isolates, and their susceptibility patterns were reviewed. A total of 77 patients were included in the study wherein 36% had no infection, 42% had wound colonization, and 22% developed burn wound infection. Among these patients, 98 specimens were sent for culture studies which revealed Acinetobacter baumannii (25.6%) as the top pathogen isolated, followed by Enterococcus sp. (21.95%), and Pseudomonas sp. (18.29%). Acinetobacter baumannii was also the top isolate among patients with local and invasive infection (86 and 67%, respectively). Multidrug resistance was observed with A. baumannii and Pseudomonas exhibiting resistance towards meropenem, imipenem, cefepime, ciprofloxacin, and piperacillin-tazobactam but remained sensitive to colistin, amikacin, and minocycline. Vancomycin, cotrimoxazole, and ciprofloxacin were active against Gram-positive bacteria. Multidrug-resistant organisms pose a major risk in all burn units. To limit their growth, judicious use of antibiotics, aggressive infection control measures, close surveillance, and frequent antibiograms are needed.