Bacteriological and Antibiotic Susceptibility Profile of Aerobic Burn Wound Isolates at a Tertiary Care Institute in Northern India

Abstract

Burn injury which itself is a life-threatening event is associated with high mortality and morbidity due to associated burn wound infection (BWI). Thermal destruction of the skin barrier and concomitant depression of local and systemic host cellular and humoral immune responses are pivotal factors contributing to infectious complications in patients with severe burns. In burns involving more than 40% of the total body surface area (TBSA) almost 75% of all deaths are either due to sepsis from burn wound infection or infection related complications and/or inhalation injury. The survival rates for burn patients have however improved substantially in the past few decades due to advances in modern medical care in specialized burn centers. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary care, burn wound care, and infection control practices. The present study was undertaken to provide an insight into the pattern of the nosocomial burn wound infections and their antibiotic susceptibility pattern occurring in the burn unit of Government Medical College & Hospital, Jammu. It was found that BWI was significantly common in older age group with type of burn injury, i.e., flame, scald, electric having no influence on the incidence of infection. However patients with higher TSBA were more likely to develop wound infections. There was a transition of bacterial growth form Gram-positive (Staphylococcus aureus being the most common) during the first week to Gram-negative (Klebsiella species being the most common) in the subsequent weeks of stay. With prolonged hospital stay an increased incidence of BWIs having identical antibiograms was observed.