Emerging trends of antimicrobial sensitivity and resistance pattern and drug utilization study in burn patients at tertiary care teaching hospital

Abstract

Background: One of the cases of accidental injuries is burns. Globally, every year estimated 180,000 mortalities occur due to burns, and most of the deaths are seen in the lower or poor socioeconomic class of developing countries. Due to predominantly poor and low socioeconomic status, overpopulation, poor education, and unreachability to advanced burn care in certain parts of the country - the incidence, complications, and deaths have continued to rise in developing countries. About 75% of the deaths associated with burn injuries are related to wound infection, especially in developing countries. The present study was undertaken to study the microflora of burn wounds as well as drug utilization in the management of burn patients in a tertiary care teaching hospital. Aims and objectives: Assessment of antimicrobial susceptibility and resistant pattern and drug utilization in burns patients. Materials and Methods: This observational cross-sectional descriptive study was performed on 130 hospitalized burn patients over 12 months (from November 2020 to November 2021). All burn patients who were admitted in the hospital and received at least 1 day of treatment were included in the study. All required information, including demographic data, prescribed medication, microbial culture sensitivity report, and treatment outcome were recorded in the case record form. Descriptive statistics using Microsoft Excel version 2019. Results: Of a total of 130 burn patients, 52% were females. The most common type of burn was flame in 69% of patients. The mean length of hospital stay was 9 days and it ranged from 1 to 40 days. Culture from burns wound revealed Pseudomonas aeruginosa (47.6%) as the most common organism isolated followed by Klebsiella pneumoniae (45.2%), Acinetobacter baumannii (14.2%), Proteus mirabilis (14.2%), Staphylococcus aureus (9.5%), and Escherichia coli (4.7%). Among the isolated microorganisms, most of them showed sensitivity to beta-lactam, aminoglycoside, and tetracyclines. Sulphonamide was dominant among the topically applied antibiotics, whereas cephalosporins were dominant among the systemically administered antibiotics. The average number of drugs pre-prescription ranges from 6.5 to 8.5. Conclusion: The present study results are helpful in understanding the pattern of burns wound sepsis, the dominant bacterial organism, the antimicrobial susceptibility/resistance, and the drug utilization pattern in burn patients.