FREQUENCY OF GRAM NEGATIVE MICROORGANISMS IN BURN PATIENTS PRESENTED TO THE BURNS & PLASTIC SURGERY UNIT, AYUB TEACHING HOSPITAL ABBOTTABAD
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Keywords
Burn injury, Infection, Sensitivity.
Abstract
Study Design: Cross-sectional observational study.
Setting & Duration: Department of Burns & Plastic Surgery, Ayub Teaching Hospital Abbottabad from November 2023 to April 2024.
Methodology: Fourteen patients who developed clinical signs of burn wound infections were selected purposely from a total of 150 patients. Patients with other diseases that were unrelated to the bacterial infections of burn wounds, including those with non-infected burns, or those with injuries that affected their immune system, like HIV infected patients, were also excluded from the study, to ensure emphasis was made on infections by only Gram-negative bacteria in burns.
Results: The mean age of the patients was 37.9 years, ranging from 23 to 60 years. The majority of patients (60%) were male, while females accounted for 40%. The types of burns encountered were predominantly flame burns (40%), followed by scald burns (25%), electrical burns (20%), and chemical burns (15%). The total body surface area (TBSA) burned varied significantly; with most patients (50%) having burns involving more than 25% of their body surface. The average duration of hospitalization was 17.5 days; with patients suffering from extensive burns (≥30% TBSA) requiring longer hospital stay. The microbial cultures revealed that Pseudomonas aeruginosa was the most prevalent bacterium, followed by Klebsiella pneumonia, Escherichia coli and Acinetobacter baumannii.
Conclusion: The findings of this study emphasize the importance of GN bacilli, especially Pseudomonas aeruginosa and Acinetobacter baumannii in burns wound infection implying most of the organisms as Multi Drug Resistance (MDR). The high frequency of MDR bacteria underlines the necessity for better infection measures, frequent microbial sampling and correct use of antibiotics in severe burn centers.
References
2. Ruegsegger L, Xiao J, Naziripour, A, Kanumuambidi T, Brown D, Williams F, et al . Multi - drug resistant gram-negative bacteria in burn patients. Antimicrobial agents and chemotherapy 2022; 66 (9): e00688- 22.
3. Haghighifar E, Kamali DR. Bacterial infections and antimicrobial resistance patterns of burn wound infections: A one year study from burn Hospital, Isfahan, Iran. JAMBR 2020; 28 (128): 144- 150.
4. Tchakal MA, Abdouni MA, Metref M. Prevalence Of multidrug-resistant bacteria isolated from burn wounds In Algeria. Annals of Burns and Fire Disasters 2021; 34(2): 150.
5. Cabral L, Afreixo V, Meireles R, Vaz M, Frade JG, et al. Evaluation of procalcitonin accuracy for the distinction between Gram-negative and Gram-positive bacterial sepsis in burn patients. JBCR 2019; 40 (1): 112- 119.
6. Shahzad M, Ayub S, Khan MA. Frequency of multidrug-resistant organisms in burn wounds: A study from northern Pakistan. JAMC 2020; 32(3): 482- 486.
7. Kabanangi F, Joachim A, Nkuwi EJ, Manyahi J, Moyo S, et al. High Level of Multidrug ‐ Resistant Gram‐Negative Pathogens Causing Burn Wound Infections in Hospitalized Children in Dar es Salaam, Tanzania. IJM 2021; (1): 6644185.
8. Chelkeba L, Melaku T, Mega TA. Gram-negative bacteria isolates and their antibiotic-resistance patterns in patients with wound infection in Ethiopia: a systematic review and meta-analysis. Infections and Drug Resistance 2021; 11: 277- 302.
9. Norbury W, Herndon DN, Tanksley JD. Infection in burns patients. Infectious Disease Clinics of North America 2016; 30(3): 693- 710.
10. Corcione S, Pensa A, Castiglione A, Lupia T, Bortolaso B, et al. Epidemiology, prevalence and risk factors for infections in burn patients: results from a regional burn centres analysis. Journal of Chemotherapy 2021; 33(1): 62-66.
11. Lari AR, Bahrami A, Lotfi R, Alaghehbandan R. Antimicrobial resistance and trends in pathogens isolated from burn patients in a burn center in the Middle East. JBCR 2015; 36 (5): 526- 533.
12. Zafar A, Naeem T, Qamar S. Multidrug-resistant Gram-negative bacteria in burn patients: Prevalence and treatment options. PJMS 2013; 29(4): 1055-1060.
13. Bonine NG, Berger A, Altincatal A, Wang R, Bhagnani T, et al. Impact of delayed appropriate antibiotic therapy on patient outcomes by antibiotic resistance status from serious gram-negative bacterial infections. AJMS 2019; 357(2): 103-110.
14. Taneja N, Biswal M, Sharma M. Emergence of carbapenem-resistant non-fermenting Gram-negative bacilli in burn patients: A cause for concern. JIPH 2013; 6(5): 301- 308.
15. Harada LK, Silva EC, Campos WF, Del Fiol FS, Vila M, et al. Bacteriophages and their applications as antimicrobials in burn wound infections: A review. Burns 2018; 44(7): 1610-1623.
16. Kim JH, Park JK, Cho JH, Kim KH. Prevalence of multidrug-resistant Acinetobacter baumannii in burn patients: Experience of a burn center in South Korea. JWC 2012; 21(7): 332- 335.
17. Khawcharoenporn T, Apisarnthanarak A, Mundy LM. High mortality from bacterial sepsis in developing countries: The effect of delaying appropriate antimicrobial treatment. CCM 2014; 42 (5): 1298- 1306.
18. Javanmardi F, Emami A, Pirbonyeh N, Rajaee M, Hatam G, et al. Study of multidrug resistance in prevalent Gram-negative bacteria in burn patients in Iran: a systematic review and meta-analysis. Journal of Global Antimicrobial Resistance 2019; 19: 64- 72.
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Dr. Zahid Iqbal Bhatti
FCPS (Plastic Surgery), Assistant Professor, Burns & Plastic Surgery Unit, Nawaz Shareef Medical College, Gujrat, Pakistan.
Dr. Sarfaraz Ahmad
Associate Professor of Plastic Surgery, KMSMC/AIMTH Sialkot, Pakistan.
Dr. Firdous Khan
Assistant Professor, Burns & Plastic Surgery Unit, Ayub Teaching Hospital, Abbottabad, Pakistan.