Burn Infection Research Articles

Inhibitory Effects of Iron Oxide Nanoparticles Biosynthesized by Prodigiosin Pigment Against Clinical Bacteria Isolates of Pseudomonas aeruginosa

The current study aimed to reveal the biosynthesis technique of Fe2O3 nanoparticles by using prodigiosin pigment production from Serratia marcescens. One hundred and twenty samples were obtained from burn and wound infections to isolate Pseudomonas aeruginosa. In addition, the optimum conditions for Fe2O3 nanoparticles biosynthesis were characterized via different methods, including ultraviolet-visible (UV-Vis), atomic force microscope (AFM), fourier transforms infrared (FT-IR) spectroscopy analysis, X-ray diffraction (XRD), and field emission scanning electron microscopy (FE-SEM). In particular, spherical shape particles were observed utilizing FE-SEM technique. In addition, the analysis of AFM revealed Fe2O3 NPs with an average diameter size of 50.73 nm. The influences of varied concentrations of iron nanoparticles (6.25, 12.5, 25 , 50, 100and 200 mg/ml) on a bacterial isolate of Pseudomonas aeruginosa were examined. The maximum inhibition zone of P. aeruginosa was 24 mm at a concentration of 200 mg/ml of Fe2O3 NPs, whereas the minimum inhibition zone were 10 mm located at 25 mg/ml Fe2O3 NPs concentrations.

Unveiling the antibacterial action of ambroxol against Staphylococcus aureus bacteria: in vitro, in vivo, and in silico investigation

It is critical to find novel therapeutic approaches owing to the dissemination of multidrug resistance (MDR) in pathogenic bacteria, particularly Staphylococcus aureus. FDA-drug repurposing is an important therapeutic tactic to fight MDR bacteria. Here, we inspected the antibacterial activity of ambroxol against clinical MDR S. aureus isolates. Using the broth microdilution method, ambroxol revealed minimum inhibitory concentrations (MICs) of 0.75 to 1.5 mg/mL. Also, it revealed antibiofilm action on 42.17% of the isolates by crystal violet assay. A scanning electron microscope was employed to study the antibiofilm action of ambroxol. It revealed that the association between the cells was interrupted by ambroxol, and the biofilm construction was devastated. Moreover, qRT-PCR was utilized to elucidate the consequence of ambroxol on the gene expression of efflux and biofilm. Remarkably, ambroxol has downregulated the expression of cna, fnb A, ica, nor A, nor B genes. Ambroxol’s in vivo antibacterial action was investigated using S. aureus infected burn infection. Interestingly, ambroxol has improved the histological features of the skin tissues, significantly diminished the bacterial burden, and increased the wound healing percentage. Also, it revealed a significant reduction in the immunohistochemical staining of tumor necrosis factor-alpha. Finally, the in silico investigations were performed to elucidate the potential of ambroxol on five possible targets of S. aureus. Ambroxol showed good affinities on the five investigated targets in S. aureus, with CrtM being the highest, proposing its probable role in the mechanisms for ambroxol’s action on S. aureus.

Poly(Vinyl Alcohol) Drug and PVA-Drug-Surfactant Complex Organogel with Dimethyl Sulfoxide as a Drug Delivery System.

The relevance of active research lies in the need to develop new technologies to improve drug delivery methods for the effective treatment of wound healing. Additionally, the potential application of organogels in other areas of biomedicine, such as creating medical patches with controlled drug delivery, indicates a wide range of possibilities for using this technology. This study focuses on developing controlled drug delivery systems using organogels as carriers for ceftriaxone and ofloxacin. By selecting optimal formulations, organogels were created to immobilize the drugs, facilitating their effective and sustained release. The swelling behavior of the hydrogels was studied, showing a swelling coefficient between 16 and 32%, indicating their ability to absorb liquid relative to their weight. Drug release studies demonstrated that ceftriaxone was released 1.8 times slower than ofloxacin, ensuring a more controlled delivery. Microbiological tests confirmed that the organogels containing ofloxacin exhibited antimicrobial activity against Escherichia coli, Bacillus subtilis, and Staphylococcus aureus. However, it was a challenge to estimate activity for the model antibiotic ceftriaxone due to bacterial resistance to it. Organogel poly(vinyl alcohol) (PVA)-DMSO-alginate modifications with surfactant cetylpyridinium bromide led to the formation of a polyelectrolyte complex on the interphase, allowing further enhanced the prolonged release of the drugs. The research identified that the optimal compositions for sustained drug release were organogels with compositions PVA (10%)-PVP (1%) DMSO (50%) and PVA (10%)-DMSO (50%) formulations, illustrating the transparent nature of these organogels making them suitable for ophthalmological application. Various organogels compositions (PVA-DMSO, PVA-poly(vinylpyrrolidone)-DMSO, PVA-DMSO-alginate, PVA-DMSO-PLGA, PVA-DMSO-drug-surfactant) loaded with ceftriaxone, ofloxacin, and surfactant were prepared and characterized, highlighting their potential use in antibiotic patches for wound healing. These organogels illustrate promising results for localized treatment of infections in wounds, cuts, burns, and other skin lesions.

Adhesive, Stretchable, and Photothermal Antibacterial Hydrogel Dressings for Wound Healing of Infected Skin Burn at Joints.

Dressings for infectious skin burn wounds at joints should have therapeutic functions as well as high tissue-adhesion, stretching, and self-healing properties. This makes it difficult for most hydrogel dressings to simultaneously meet the above-mentioned requirements. In this study, poly(vinyl alcohol), anhydrous sodium borax, epigallocatechin gallate, and copper chloride were used to prepare a hydrogel dressing (PBEC) for the infected burn wound healing at joints. The PBEC hydrogel can adhere to a variety of substrates, has a stretching capacity, and quickly self-healing after being damaged. Additionally, the PBEC hydrogel has the properties of reactive oxygen species scavenging, photothermal sterilization, hemostatic ability, and biocompatibility. Finally, the hydrogel could accelerate the process of wound healing in vivo, especially with the assistance of near-infrared radiation. Therefore, the hydrogel dressing shows great potential for clinical application in the healing of infected burn wounds at joints.

Inhibition of the Hyaluronidase Enzyme Produced by Staphylococcus Bacteria Using Vasicine Alkaloids of the Vasica Plant

Hyaluronidase is an enzyme that breaks down primarily hyaluronic acid, thereby disrupting the structural integrity of the extracellular matrix (ECM) found in connective tissues, which is considered a virulence factor. The aim of this research was to study the effect of a plant-active compound (vasicine) that was separated from a plant sample as an inhibitor agent for the hyaluronidase enzyme that was isolated from Staphylococcus aureus, which is considered a virulence factor. 120 samples were randomly isolated from infected burns. The isolates showing highly hydrolyzed zones were identified. Cell growth as well as hyaluronidase activity are measured spectrophotometrically by the turbidity reduction assay. The results showed that 100 out of 120 clinical samples grew bacteria when cultured on blood agar medium. Also, it was found that of the 100 isolates, 56 (56%) belonged to S. aureus and had an inhibitory zone of hyaluronidase of 5–26 mm, and the inhibitory zone was increasing over time.

Prevalence of Drug Resistance and Pathogenic Factors of Pseudomonas aeruginosa Isolates Recovered from Hospitalized Patients

Background: Humans can develop both acute and chronic infections from Pseudomonas aeruginosa, a bacterium that is a prominent cause of nosocomial infections, as well as respiratory, urinary tract, burn, wound, ear, eye, and bloodstream infections. Objectives: This study aimed to identify antibiotic resistance in P. aeruginosa strains obtained from hospitalized patients and assess the frequency of virulence genes. Methods: In this cross-sectional study, 86 strains of P. aeruginosa were isolated from patients in various hospital wards in Shiraz and Yasuj in 2021. Antibiotic susceptibility was tested using the disk diffusion method, while the frequency of virulence genes (aprA, phzM, phzS) and antibiotic resistance genes (blaGES, blaSPM, blaVIM) was evaluated using PCR and specific primers. Results: The P. aeruginosa isolates showed the highest antibiotic resistance to imipenem and the lowest resistance to piperacillin-tazobactam. PCR amplification of aprA, phzM, and phzS genes indicated that aprA had the highest frequency among the isolates, with a prevalence of 98.8%. The frequencies of phzM and phzS were 96.5% and 91.9%, respectively. Conclusions: This study revealed a high prevalence of the virulence genes aprA, phzM, and phzS in P. aeruginosa isolates. Given the bacterium’s resistance to many antibiotics, clinicians should exercise caution when prescribing antibiotics, particularly for infections caused by P.aeruginosa.

Risk factors for Beta-lactam and carbapenem-resistant bacteria causing post-burn infections

Background: Burn patients are predisposed to infection because of the loss of skin barrier protection and low immunity. This study aims to evaluate the risk factors of post-burn infections due to beta-lactam and carbapenem-resistant bacteria (CR) isolated from a major burn unit.Methods: The descriptive study was conducted at Jinnah Hospital Lahore’s Burn and Reconstructive Surgery Centre (JB & RSC) and the Institute of Microbiology and Molecular Genetics (MMG), University of the Punjab, Lahore. The clinical specimens of wound swabs, including the age, gender, socio-economic status, residence, occupation, hospital stay, wards, burn degree, total burnt surface area (TBSA%), etiology of burn, and other factors were recorded. Antimicrobial susceptibility testing (AST), ESBL and CR screening (Beta- lactam and carbapenem resistant bacteria) were performed using CLSI guidelines 2017.Results: The most dominant strain was Pseudomonas spp. 26.5% (n=106), followed by 15% (n=60) Klebsiella spp., and 7.5% (n=30) Acinetobacter spp. with ESBL-producing strains. Compared to nosocomial infections, community-acquired infections were observed in 314 (78.5%) patients with more ESBL production. There was a significant relation between burnt people having an age of ≤ 29 years with ESBL (p=0.985) and carbapenemases (p=0.694) infections. None of the other factors, like low socioeconomic status and more hospital stays had a significant correlation (p > 0.05).Concluded: It has been concluded that MDR gram-negative strains play a serious role in burn infections and demand suitable methods to decrease their number. Pseudomonas spp. was the most common post-burn infection causing bacteria. Unfortunately, a high frequency of burn infections was observed in the patients at a young age.Keywords: Post burn infections; Gram negative; MDR; Beta- lactam; Carbapenem resistant

Engineered Multifunctional Artificial Dermis for Infected Burn Wound Healing

AbstractBurn wound healing is a dynamic and interconnected process, with the complex status of the extracellular matrix (ECM) potentially leading to bacterial infections, drug resistance, or even fatality. However, it remains a grand challenge to assemble a skin‐like material showing similar biological properties as healthy ECM to accelerate burn healing. In this study, the ECM composition is closely mimicked and adaptive multifunctional artificial dermis is developed by leveraging Ag─S bonds, supramolecular interactions among recombinant proteins, Ag+, and hyaluronic acid (HA). The artificial dermis exhibits long‐lasting broad‐spectrum antibacterial activity, achieved though controlled Ag+ release via Ag─S bonds, supramolecular interactions, and recombinant protein‐guided multi‐level assembly, reaching a steady plateau of 83.7% in the later stage. It is found that inflammation is reduced by downregulating IL‐6 and TGF‐β expression. Furthermore, the epidermal growth factor (EGF) within the recombinant proteins stimulates Col1α, ELN, and CD31 upregulation, facilitating ECM remodeling. These adaptive multifunctional artificial dermis effectively address wound infections, accelerate collagen deposition, promote re‐epithelialization, and enhance angiogenesis in infected wounds, highlighting their potential to revolutionize burn wound treatment and offering a promising avenue to holistic care.

Drug loaded marine polysaccharides-based hydrogel dressings for treating skin burns

Marine polysaccharide-based biomaterials possess a range of excellent functions and properties, such as antiviral, antioxidant, immune regulation, and promoting cell migration, and are widely used in modern medicine. In this study, a marine polysaccharide-based composite hydrogel was synthesized using carboxymethyl chitosan and oxidized fucoidan as matrix, and loads therapeutic drugs for the treatment of burn wounds infected with bacteria. The composite hydrogels can slowly release drugs at the wound site, providing a long-lasting therapeutic effect including antibacterial, antioxidant, and analgesic, in this way to facilitate the restoring of infected burn wounds by inhibiting bacterial infections, promoting cell migration, facilitating collagen regeneration, and restoring the abnormal alteration of factors such as IL-1β and CD86.

Nanoemulsion is an effective antimicrobial for methicillin-resistant Staphylococcus aureus in infected swine skin burn wounds.

The findings of this study are focused on therapeutic applications of nanotechnology. In the current study, we demonstrated that a nanoemulsion formulation could effectively kill methicillin-resistant Staphylococcus aureus (MRSA) infection in porcine skin burn wounds. Infection of MRSA in burn wound is a common threat to public health and is usually difficult to treat due to limited therapies available. NB-201 was effective in significantly alleviating inflammation in the treated wounds and promoting wound healing. Therefore, the finding of this study has a great potential to make this formulation a novel antimicrobial agent against MRSA.

Factors associated with delayed admission to the burn unit: A major burn center’s experience

BackgroundTimely admission to the burn unit is crucial. Ideal burn care requires prompt interventions such as wound and body temperature management, infection control, and fluid resuscitation to prevent complications like burn progression and infection. In this study, we identify specific factors and outcomes associated with delayed admission to a regional burn center. MethodsPatients admitted to a large urban burn center from January 2015 to December 2023 were retrospectively queried, with subsequent collection of demographic and outcome variables from chart review. Descriptive statistics, Welch’s t-tests of unequal variances, and Chi-square analysis were performed. Multiple logistic regression was performed to explore the association between delayed admission and ICU stay, ventilator requirements, and mortality. ResultsA total of 3137 patients were included in the study. Approximately 63.4 % of patients were admitted within 24 h, while 36.6 % had a significant delay in care of over 24 h after injury. Male patients were likely to experience delayed admission (39.0 vs. 31.8 %, p < 0.001). There was no significant difference in age between the two cohorts (38.6 vs. 39.7 years, p = 0.199). There was no significant difference in time to admission by racial background (p = 0.061). Total body surface area burned (TBSA) varied between the delayed and control cohorts (15.5±18.7 % vs. 8.2±12.9 %, p < 0.001). Patients who were single (p < 0.001) and lived alone (p = 0.011) were more likely to experience a delay in burn unit admission. Homelessness (p < 0.001), substance abuse disorder (p < 0.001), and uninsured status (p < 0.001) were also associated with delayed admission. In regression analysis when controlling for TBSA, delay in care was significantly associated with a greater requirement for ICU stay (p < 0.001) and mechanical ventilation (p = 0.021) but was not associated with increased mortality (p = 0.232). ConclusionSociodemographic variables such as homelessness, lack of social support, and substance abuse are associated with delayed burn unit admission. Knowledge of these factors can inform future interventions to improve outcomes for vulnerable patients, promoting better recovery and long-term outcomes after burn injury.

Evaluation of the antibacterial activity of AgNPs from Lactobacillus plantarum against Acinetobacter baumannii

In this study, we isolated Acinetobacter baumannii in wounds and burn infections and assessed the impact of silver nanoparticles (AgNPs) produced from an external extract of Lactobacillus plantarum secretion on the bacterial growth. Characterization of AgNPs was done using TEM, XRD and FTIR spectroscopy. Inhibition diameters of five concentrations of AgNPs were prepared from Lactobacillus plantarum extracts against A. baumannii. A diameter of 20mm was observed for the highest concentration of 500mg\ml while 16 mm was observed for a concentration of 250mg\ml and 8 mm for the lowest concentration of 50mg\ml. The highest concentration of 500mg\ml showed the most significant inhibition. All concentrations of AgNPs were effective in inhibiting the growth of A. baumannii.

Gene expression of psID gene in Pseudomonas aeruginosa isolated from clinical causes

One hundred clinical samples were collected from Baghdad hospitals including Teaching Laboratories Hospital, Medical City, Baghdad Teaching Hospital and Ghazi Hariri Hospital including burn infections, wound infections, urinary tract infections, otitis media from May 2022 to September 2022, The samples were identefied by microscopic, phenotypic and culturale on MacConkey agar and by biochemical tests including oxidase, catalase, citrate utilization test, triple sugar-iron test (TSI), gelatinase test, motility test and ornithine decarboxylation test. After diagnosis, we received 19 isolates of Pseudomonas aeruginosa . To detection biofilm genes used PslD gene, we all (19) isolates of Pseudomonas aeruginosa have these genes in percentage 100% with a molecular weight of 295 base pair. The gene expression study was done to evaluate the gene expression of the PslD biofilm gene using three concentrations of cefotaxim antibiotic (2, 4 and 8) μg/ml. Only two concentrations 2 and 8 μg/ml of cefotaxim had gene expression results of psID gene, 19.32 at RNA concentration when treated with 2 μg/ml of cefotaxim, 22.56 at RNA concentration when treated with 8 μg/ml of cefotaxim and undetermined at RNA concentration when treated with 4 μl/ml of cefotaxim.

Antibacterial and Healing Efficacy of Mangiferin-Loaded Silver Nanoparticle and Chitosan-Alginate Membrane Dressings

Mangiferin, a bioactive constituent of Mangifera indica (family Anacardiaceae), has an impressive therapeutic profile, having antioxidant, anti-inflammatory, analgesic, antibacterial, and immunomodulatory properties capable of possessing wound healing potential. Our investigation aims to isolate and characterize mangiferin, green synthesis of silver nanoparticles (Ag-NPs) and production of chitosan alginate (Cs/Alg) film dressing loaded with mangiferin Ag-NPs and assess antibacterial and wound-healing properties against infected excision and burn wounds. The isolated mangiferin was authenticated by estimating melting point, thin layer chromatography (TLC), fourier-transform infrared spectroscopy (FTIR), and high-performance liquid chromatography (HPLC). Ag-NPs were green synthesized and characterized by UV-visible, particle size, zeta potential (ZP), entrapment efficiency (%EE), scanning electron microscope (SEM), transmission electron microscope (TEM), and stability study. Chitosan alginate membrane dressing was prepared by incorporating mangiferin Ag-NPs, and film thickness, pH, film weight, water intake capacity, and in-vitro drug release parameters were estimated. Among the four mangiferin Ag-NP batches, MN3 formed stable polydispersity spherical Ag-NPs with smaller particle size and high %EE. Mangiferin-loaded Cs/Alg film MN-CM4 showed significantly higher (p &lt; 0.001) drug content, wettability, release profile, and favorable pH changes. The mangiferin Ag-NPs embedded Cs/Alg film dressing showed a significantly high antimicrobial effect against the gram-positive bacterial strain of S. aureus, commonly found in wounds. MN3 and MN-CM4 treatment showed the shortest epithelialization period and enhanced wound closure. The hydroxyproline content has significantly (p &lt; 0.001) increased, and myeloperoxidase content was reduced by MN3 and MN-CM4 treatment. MN-CM4 treatment showed complete re-epithelialization reduced inflammatory cells with thicker and denser collagen fiber deposition. The effectiveness of the Cs/Alg film of mangiferin Ag-NPs dressing has a synergistic effect on promoting speedy wound healing. The Cs/Alg film of mangiferin Ag-NPs showed rapid wound healing against infected and burned wounds, enhanced collagen synthesis, and anti-inflammatory and antibacterial efficacy.

Encapsulation of Mentha aquatica methanol extract in alginate hydrogel promotes wound healing in a murine model of Pseudomonas aeruginosa burn infection

Burn injuries are the fourth most prevalent devastating form of trauma worldwide. Among the most extensively explored materials, composite dressings with alginate loaded with herbal extract can be mentioned. This research aimed to develop a sodium alginate (SA)-based hydrogel encapsulated with Mentha aquatica (MA) methanol extract and investigate its therapeutic efficacy in the infected burn mouse model. SEM, FTIR, in vitro extract release, HPLC, mechanical test, contact angle, swelling, degradability, and temperature response properties were used to analyze the hydrogel scaffold's physicochemical structure. Additionally, the antibacterial activity and MIC level of the extract, cell cytotoxicity, and macroscopic and microscopic analysis of the wound healing process were done using Masson's trichrome and hematoxylin-eosin staining. The physicochemical properties of the SA hydrogel encapsulated with MA extract were verified. The lowest inhibitory dose of the extract was determined to be 12.5 mg/ml. Application of SA/MA hydrogel to localized wounds of deep third-degree burns demonstrated faster tissue regeneration, collagen recovery, and eradication of bacterial infection. This research focused on the design and the preparation of a novel and effective biomaterials-based medical product, which has the potential to rehabilitate infected and injured skin tissue; therefore, it can be a promising candidate for wound dressing applications.

Alarming Prevalence of Nosocomial Pseudomonas aeruginosa among Patients with Infected Burn Wounds

Background: Recently, the prevalence of nosocomial Pseudomonas aeruginosa has become a concern due to its involvement in increased morbidity and mortality, especially those highly virulent strains associated with burn wounds in burn centers. Therefore, this cross-sectional study aimed to isolate and determine the prevalence of nosocomial Pseudomonas aeruginosa among burned inpatients. This study was carried out between September 2023 and March 2024. A total of 355 pus, purulent fluid and necrotic tissue swabs were obtained from burn victims with burns at the Burn Centers in Najaf City, Iraq. 85/355 (23.9%) of isolates under study were detected as Pseudomonas aeruginosa based on laboratory methods (microscopic, biochemical and culture). All test isolates appeared to grow optimally on cetrimide and chromium agar media, and colonies appeared green on these media when examined by the naked eye and greenish fluorescence under ultraviolet light. However, colonies on blood agar were bright and metallic, and the most common type of lysis was β-hemolysin followed by α-hemolysin. On Nutrient agar, most of the isolates were characterized by positive multi-pigment production 57/85 (67.1%), while 28/85 (32.9%) of the isolates were negative pigment production. Conclusion: The rate of virulent P. aeruginosa in the current study raises the degree of alarm, especially among burn patients because they do not have the means of defense that qualify them to resist this virulent pathogen. Also, the older age groups were more affected by it, which increases the levels of risk because elderly patients have weak immunity in addition to most of them being infected with other diseases such as diabetes, which increases the complications associated with burn infections. The impact of Pseudomonal infections on females in most age groups was one of the results of utmost importance and the real reasons behind it must be known. According to numerous studies and reports, the possession of this dangerous pathogen of multiple virulence factors such as its ability to form biofilms delays or prevents the patient's recovery and increases the likelihood of death in burn inpatients. Also, the possession of these virulent bacteria of a large genome makes them exceptionally adaptable and resistant to unfavorable environments.

Design and Evaluation of Microemulsion-Based Drug Delivery Systems for Biofilm-Based Infection in Burns

Normal skin is the first line of defense in the human body. A burn injury makes the skin susceptible to bacterial infection, thereby delaying wound healing and ultimately leading to sepsis. The chances of biofilm formation are high in burn wounds due to the presence of avascular necrotic tissue. The most common pathogen to cause burn infection and biofilm is Pseudomonas aeruginosa. The purpose of this study was to create a microemulsion (ME) formulation for topical application to treat bacterial burn infection. In the present study, tea tree oil was used as the oil phase, Tween 80 and transcutol were used as surfactants, and water served as the aqueous phase. Pseudo ternary phase diagrams were used to determine the design space. The ranges of components as suggested by the design were chosen, optimization of the microemulsion was performed, and in vitro drug release was assessed. Based on the characterization studies performed, it was found that the microemulsion were formulated properly, and the particle size obtained was within the desired microemulsion range of 10 to 300 nm. The I release study showed that the microemulsion followed an immediate release profile. The formulation was further tested based on its ability to inhibit biofilm formation and bacterial growth. The prepared microemulsion was capable of inhibiting biofilm formation.Graphical

Diagnosis and Treatment of Infections in the Burn Patient.

Infection is very common in burn patients because they lose the primary barrier from microorganism invasion, the skin. While there are attempts to prevent infections, topical antimicrobials and systemic prophylaxis tend to lead to more resistant organisms. After the initial resuscitation, the most common cause of death is from sepsis and multiple organ dysfunction syndrome. The diagnosis is difficult in the burn population because the constant exposure from the open wound leads to an inflammatory response that leads to persistent hypermetabolism. This paper reviews the current understanding and treatment of infection and sepsis in burns.

Prospects for the application of cell therapy in combustiology

Currently, one of the urgent problems in the field of surgery and traumatology is burn injury. A significant part of the victims has deep and extensive burns, the treatment of which is the most difficult problem of modern combustiology. In this aspect, one of the main problems faced by surgeons in combustiology is the lack of donor material and an increased risk of complications of burn wounds. In this regard, the most promising direction in kombustiology is the application of cell engineering methods, including the use of fibroblasts and stem cells. Fibroblasts have a number of advantages, such as efficiency, safety and accessibility. Stem cells are also a common method of cell therapy, they have great potential in regenerative processes. Mesenchymal stem cells (MSCs), which have a pronounced regenerative and immunosuppressive effect, are also used in kombustiology. In the treatment of infected burn wounds, phage therapy, which provides lysis of infectious pathogens, showed a positive result. In addition to fighting pathogens, bacteriophages, like MSCs, have an immunosuppressive effect, thereby reducing the risk of transplant rejection.

Recent trends in antibiotic sensitivity and resistance patterns in infected wounds of burns patients presented to a tertiary care hospital.

Objective: To study the recent trends and patterns of antibiotic sensitivity and resistance in infected wounds of burns patient. Study Design: Cross sectional study. Setting: Burns and Plastic Surgery Canter, Peshawar, Pakistan. Period: July 30th to January 30th, 2023. Methods: In this cross sectional study we adopted convenience sampling technique. A total of 75 samples collected from patients fitted to our infected patients criteria and culture and sensitivity tests were performed using standard microbiological techniques. Results: Among the positive infected wound samples, Klebsiella Species were found in 23 (30.7%), Pseudomonas Aeruginosa in 16 (21.3%), Acinetobacter Species in 14(18.7%), Proteus Species in 8(10.7%), Citrobacter species in 5(6.6%), Staph. Aureus in 5(6.6%), Enterobacter species in 3(4%) and E.coli in 1(1.4%) of the positive cultures. Each pathogen showed varying degree of sensitivity and resistance patterns to different antibiotics tested. Conclusion: Klebsiella Species was the most common pathogen in patients with infected burns wounds. Meropenem, imipenem, Doripenem, Piperacillin/Tazobactum, Colistin, and Tigecyclin were found to be effective against the majority of the bacteria. Conversely, most of the bacterial strains exhibited resistance to commonly prescribed antibiotics such as co-amoxiclave, ampicillin, ceftriaxone, ciprofloxacin, cefotaxime and co-trimoxazole.