Volume 12, Issue 2 (6-2024)                   JoMMID 2024, 12(2): 150-158 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Roohi S, Ara Mir A, Ahmed T, Khaja F, Qayoom T, Bali N. A Four-Year Retrospective Study on Epidemiology, Bacteriology, and Antimicrobial Resistance of Bacterial Isolates from Burn Wounds in a Tertiary Care Hospital. JoMMID 2024; 12 (2) :150-158
URL: http://jommid.pasteur.ac.ir/article-1-617-en.html
A Four-Year Retrospective Study on Epidemiology, Bacteriology, and Antimicrobial Resistance of Bacterial Isolates from Burn Wounds in a Tertiary Care Hospital
Shagufta Roohi , Anjum Ara Mir * , Tufail Ahmed , Fakhri-Zehra Khaja , Tabish Qayoom , Nargis Bali
Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India
Abstract:   (263 Views)
Introduction: Burn wound infections are a significant cause of morbidity and mortality among burn patients. Understanding of the prevalent bacterial etiologies and their antimicrobial susceptibility patterns within a healthcare facility is crucial for optimizing management strategies. Methods: This retrospective descriptive study was conducted over a four-year period at the Department of Microbiology in a tertiary care facility. We analyzed swab and pus samples collected from burn wound patients admitted to the Department of Plastic Surgery. Demographic data, including age and gender, were collected. Positive bacterial cultures underwent Gram staining and culture for identification. Biochemical tests were used for species-level identification. Antimicrobial susceptibility testing was performed using the disk diffusion method according to CLSI guidelines. Statistical analyses were carried out using SPSS software version 23 employing the chi-square test. Results: Out of 750 swab and pus samples analysed, 556 (74.1%) yielded positive bacterial cultures. Gram-negative bacteria predominated, accounting for 475 (85.4%) isolates, while 81 (14.6%) were Gram-positive. The most prevalent pathogens were Pseudomonas aeruginosa (175, 31.47%), Klebsiella pneumoniae (100, 17.99%), and Acinetobacter baumannii (68, 12.23%). Notably, 80.5% of P. aeruginosa isolates exhibited multidrug resistance (MDR). Among Staphylococcus aureus isolates, 37 (72.7%) were methicillin-resistant (MRSA). Conclusions: Among all isolates, P. aeruginosa was the most prevalent bacterial pathogen. S. aureus was the most prevalent Gram-positive organism. 72.7% of S. aureus isolates were MRSA. The high prevalence of multidrug-resistant P. aeruginosa and MRSA underscores the importance of implementing an antimicrobial stewardship program guided by local antibiograms.
 
Keywords: Burn wounds, Epidemiology, Gram-negative bacteria, Tertiary care hospital
Full-Text [PDF 980 kb]   (79 Downloads)    
Type of Study: Original article | Subject: Anti-microbial agents, resistance and treatment protocols
Received: 2023/11/3 | Accepted: 2024/09/20 | Published: 2024/09/18
References
1. Mater ME, Yamani AE, Aljuffri AA, Binladen SA. Epidemiology of burn-related infections in the largest burn unit in Saudi Arabia. Saudi Med J. 2020; 41 (7): 726-32. [DOI:10.15537/smj.2020.7.25141]
2. Honnegowda TM, Kumar P, Udupa P, Rao P. Epidemiological study of burn patients hospitalised at a burns centre, Manipal. Int Wound J. 2019; 16 (1): 79-83. [DOI:10.1111/iwj.12995]
3. Markiewicz-Gospodarek A, Kozioł M, Tobiasz M, Baj J, Radzikowska-Büchner E, Przekora A. Burn Wound Healing: Clinical Complications, Medical Care, Treatment, and Dressing Types: The Current State of Knowledge for Clinical Practice. Int J Environ Res Public Health. 2022; 19 (3): 1338. [DOI:10.3390/ijerph19031338]
4. Chaudhary NA, Munawar MD, Khan MT, Rehan K, Sadiq A, Tameez-Ud-Din A, et al. Epidemiology, Bacteriological Profile, and Antibiotic Sensitivity Pattern of Burn Wounds in the Burn Unit of a Tertiary Care Hospital. Cureus. 2019; 11 (6): e4794. [DOI:10.7759/cureus.4794]
5. Gupta M, Naik AK, Singh SK. Bacteriological profile and antimicrobial resistance patterns of burn wound infections in a tertiary care hospital. Heliyon. 2019; 5 (12): e02956. [DOI:10.1016/j.heliyon.2019.e02956]
6. Mandal A, Das S. Bacteriological profile with antibiotic sensitivity pattern of burn wound infections in a peripheral tertiary care hospital. Int Surg J. 2021; 8 (4): 2349-3305. [DOI:10.18203/2349-2902.isj20211307]
7. Pednekar A, Paul KM, Prakash J, Hepsy YS, Barreto E, Gupta AK, et al. Emerging trends of antimicrobial susceptibility and resistance in burn patients. Burns Open. 2019; 3 (2): 51-5. [DOI:10.1016/j.burnso.2019.01.002]
8. Bassetti M, Peghin M, Vena A, Giacobbe DR. Treatment of Infections Due to MDR Gram-Negative Bacteria. Front Med. 2019. 16; 6: 74. [DOI:10.3389/fmed.2019.00074]
9. Ruegsegger L, Xiao J, Naziripour A, Kanumuambidi T, Brown D, Williams F, et al. Multidrug-Resistant Gram-Negative Bacteria in Burn Patients. Antimicrob Agents Chemother. 2022; 66 (9): e0068822. [DOI:10.1128/aac.00688-22]
10. Winn W, Allen S, Janda W, Koneman E, Procop G, Schreckenberger P, et al. (2006) Koneman's Color Atlas and Textbook of Diagnostic Microbiology (6th ed.), Lippincott Williams and Wilkins, Philadelphia, PA.
11. Clinical and Laboratory Standards Institute. (2023). Performance standards for antimicrobial susceptibility testing (33rd ed.). CLSI (M100).
12. Lachiewicz AM, Hauck CG, Weber DJ, Cairns BA, van Duin D. Bacterial Infections After Burn Injuries: Impact of Multidrug Resistance. Clin Infect Dis. 2017; 65 (12): 2130-36. [DOI:10.1093/cid/cix682]
13. Sharma S, Bajaj D, Sharma P. Fungal Infection in Thermal Burns: A Prospective Study in a Tertiary Care Centre. J Clin Diagn Res. 2016; 10 (9): PC05-PC07. [DOI:10.7860/JCDR/2016/20336.8445]
14. Gong Y, Peng Y, Luo X, Zhang C, Shi Y, Zhang Y et al. Different Infection Profiles and Antimicrobial Resistance Patterns Between Burn ICU and Common Wards. Front Cell Infect Microbiol. 2021. 11: 681731. [DOI:10.3389/fcimb.2021.681731]
15. Church D, Elsayed S, Reid O, Brent Winston B, Lindsay R. Burn Wound Infections. Clin Microbiol Rev. 2006; 19 (2): 403-34. [DOI:10.1128/CMR.19.2.403-434.2006]
16. Mahrok M, Keshavarzi A, Pirbonyeh N, Javanmardi F, Khoob F, Emami A. Plasmid-related β-lactamase genes in Pseudomonas aeruginosa isolates: a molecular study in burn patients. J Med Microbiol. 2019; 68 (12): 1740-46.
17. Lamichhane A, Nakarmi KK, Dahal P, Basnet SJ, Pokharel PB, Bhattarai S, et al. Bacteriological Profile of Burn Patients and Antimicrobial Susceptibility Pattern of their Wound Isolates at Nepal Cleft and Burn Center. NMCJ. 2019; 15 (3): 160-6. [DOI:10.3126/jcmsn.v15i3.24363]
18. Emami A, Pirbonyeh N, Keshavarzi A, Javanmardi F, Moradi Ghermezi S, Ghadimi T. Three Year Study of Infection Profile and Antimicrobial Resistance Pattern from Burn Patients in Southwest Iran. Infect Drug Resist. 2020; 13: 1499-1506. [DOI:10.2147/IDR.S249160]
19. Lam NN, Hung NT, Duc NM. Influence of gender difference on outcomes of adult burn patients in a developing country. Ann Burns Fire Disasters. 2019; 32 (3): 175-8. [DOI:10.1016/j.burnso.2019.05.003]
20. Mehta K, Arega H, Smith NL, Li K, Gause E, Lee J, Stewart B. Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study. Am J Surg. 2022; 223 (1): 157-163. [DOI:10.1016/j.amjsurg.2021.07.041]
21. AbuIbaid AH, Hebron CA, Qaysse HA, Coyne MJ, Potokar TS, Shalltoot FA, et al. Epidemiology, aetiology and knowledge, attitudes, and practices relating to burn injuries in Palestine: A community-level research. Int Wound J. 2022; 19 (5): 1210-20. [DOI:10.1111/iwj.13716]
22. Padmaja N, Kamala P, Kanakadurgamba, Lavanya K, Ratankumari P. Study Of Bacteriological Profile And Antibiogram Of Burn Wound Patients In A Tertiary Care Hospital, Visakhapatnam. Eur J Cardiovasc Med. 2023; 13 (1): 487-90.
23. Lakshmi N, Koripella R, Manem J, Krishna PB. Bacteriological profile and antibiogram of burn wound infections in a tertiary care hospital. IOSR J Dental Med Sci. 2015; 14: 1-4.
24. Datta S, Ghosh T, Sarkar D, Tudu NK, Chatterjee TK, Jana A. Bacteriological Profile of Burn Wounds and Their Antibiotic Susceptibility Pattern in a Tertiary Care Hospital. Int J Sci Stud. 2016; 4 (5): 141-5.
25. Ebenezer R, Princess I, Vadala R, Kumar S, Ramakrishnan N, Krishnan G. Microbiological Profile of Infections in a Tertiary Care Burns Unit. Indian J Crit Care Med. 2019; 23 (9): 405-10. [DOI:10.5005/jp-journals-10071-23234]
26. Garg I, Pargal P, Oberoi A, Obed VAE. Bacteriological Profile of Burn Patients in a Tertiary Health Care Centre. J Evol Med Dent Sci. 2019; 8 (50): 3579-63. [DOI:10.14260/jemds/2019/814]
27. Kaita Y, Otsu A, Tanaka Y, Yoshikawa K, Matsuda T, Yamaguchi Y. Epidemiology of bloodstream infections and surface swab cultures in burn patients. Acute Med Surg. 2022; 8; 9 (1): e752. [DOI:10.1002/ams2.752]
28. Gonzalez MR, Fleuchot B, Lauciello L, Jafari P, Applegate LA, Raffoul W, et al. Effect of Human Burn Wound Exudate on Pseudomonas aeruginosa Virulence. mSphere. 2016; 1 (2): e00111-15. [DOI:10.1128/mSphere.00111-15]
29. Reygaert WC. An overview of the antimicrobial resistance mechanisms of bacteria. AIMS Microbiol. 2018; 4 (3): 482-501. [DOI:10.3934/microbiol.2018.3.482]
30. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012; 18 (3): 268-81. [DOI:10.1111/j.1469-0691.2011.03570.x]
31. Dawra R, Sharma R, Bachhiwal R, Vyas A. High Incidence of Multidrug Resistant Pseudomonas aeruginosa Isolated from Infected Burn Wounds in a Tertiary Hospital. Int J Curr Microbiol App Sci. 2017; 6 (2): 1134-9. [DOI:10.20546/ijcmas.2017.602.128]
32. Kabanangi F, Joachim A, Nkuwi EJ, Manyahi J, Moyo S, Majigo M. High Level of Multidrug-Resistant Gram-Negative Pathogens Causing Burn Wound Infections in Hospitalized Children in Dar es Salaam, Tanzania. Int J Microbiol. 2021; 6644185. [DOI:10.1155/2021/6644185]
33. Zampar EF, Anami EHT, Kerbauy G, Queiroz LFT, Carrilho CMDM, Cardoso LTQ, et al. Infectious complications in adult burn patients and antimicrobial resistance pattern of microorganisms isolated. Ann Burns Fire Disasters. 2017; 30 (4): 281-5.
34. Bhatt P, Rathi KR, Hazra, S, Sharma AK, Shete V. Prevalence of multidrug resistant Pseudomonas aeruginosa infection in burn patients at a tertiary care centre. Indian J Burns. 2015; 23: 56-9. [DOI:10.4103/0971-653X.171656]
35. Cato LD, Al-Tarrah K, Moiemen N. Changes in Burn Wound Microbiology Profile Over 14 Years of an Adult Tertiary Burn Center. J Burn Care Res. 2023; 44 (2): 293-301. [DOI:10.1093/jbcr/irab184]
36. Chen X, Xu J, Zhu Q, Ren Y, Zhao L. Polymyxin B resistance rates in carbapenem-resistant Pseudomonas aeruginosa isolates and a comparison between Etest® and broth microdilution methods of antimicrobial susceptibility testing. Exp Ther Med. 2020; 20 (2): 762-9. [DOI:10.3892/etm.2020.8777]
37. Hosseininassab Nodoushan SA, Yadegari S, Moghim S, Isfahani BN, Fazeli H, Poursina F, et al. Distribution of the Strains of Multidrug-resistant, Extensively Drug-resistant, and Pandrug-resistant Pseudomonas aeruginosa Isolates from Burn Patients. Adv Biomed Res. 2017; 6: 74. [DOI:10.4103/abr.abr_239_16]
38. Fu Y, Xie B, Ben D, Lv K, Zhu S, Lu W, et al. Pathogenic alteration in severe burn wounds. Burns. 2012; 38 (1): 90-4. [DOI:10.1016/j.burns.2011.02.006]
39. Cen H, Wu Z, Wang F, Han C. Pathogen distribution and drug resistance in a burn ward: a three-year retrospective analysis of a single center in China. Int J Clin Exp Med. 2015; 8 (10): 19188-99.
40. Bang RL, Sharma PN, Sanyal SC, Bang S, Ebrahim MK. Burn septicaemia in Kuwait: associated demographic and clinical factors. Med Princ Pract. 2004; 13 (3): 136-41. [DOI:10.1159/000076952]
41. Qader AR, Muhamad JA. Nosocomial infection in Sulaimani Burn Hospital, Iraq. Ann Burns Fire Disasters. 2010; 23 (4): 177-81.
42. Chatterjee SS, Otto M. Improved understanding of factors driving methicillin-resistant Staphylococcus aureus epidemic waves. Clin Epidemiol. 2013; 5: 205-17. [DOI:10.2147/CLEP.S37071]
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.