Antibiotic Resistance Pattern in Aerobic Gram Negative Bacterial Infection in Burn Patient’s at Tertiary Care Hospital in Maharashtra

Background and objective: The present study performed on patients admitted in burns unit to determine aerobic bacterial flora of burn wound infection and to study their antibiogram. Methods: A total of 277 cases of different percentage of burns were studied for isolation of microbes. Bacterial isolates were identified by conventional biochemical methods and antibiotic susceptibility was performed by KirbyBauer method. Results: From 277 patients, a total of 384 organisms were isolated from burn wound swabs. Pseudomonas aeruginosa (20.05%) were the most common isolate followed by Proteus species (16.40%), Klebsiella pneumoniae (16.14%), Acinetobacter baumannii (8.59%), Citrobacter freundii (6.25%), Escherichia coli (4.42%) and Enterobacter spp (3.38%). Pseudomonas aeruginosa and Proteus species shows good sensitivity to piperacillin/tazobactam (67.53%). Conclusions: In conclusion, this study shows that various factors involved in the burn wound infections. There is continuous changing pattern of infecting organism and multidrug resistance among them. So continuous microbiological surveillance and regular antimicrobial susceptibility pattern helps to clinician in treatment and prevention of multidrug resistance in our burn unit. It also helps in institution guideline for antibiotics. Key-words: Burns, Antibiotic sensitivity Test. INTRODUCTION Burn injury is a major problem in many parts of the world. It has been estimated that 75 % of all deaths following burns are related to infection. [1] Burn wound infection and septicemia still remains a major problem. [2] Cross infection results between different burn patients due to overcrowding in burn wards. [3] The emergence worldwide of antimicrobial resistance among a wide variety of human bacterial and fungal burn wound pathogens, particularly nosocomial isolates, limits the available therapeutic options for effective treatment of burn wound infections. [4] Emerging antimicrobial resistance trends in burn wound bacterial pathogens represent a serious therapeutic challenge for clinicians caring for burn. [5] MATERIALS AND METHODS The study was conducted in department of microbiology, tertiary care hospital Latur, India. A total of 277 cases of different percentage of burns were studied for isolation of microbes. For sample collection large, raw, burnt area was chosen. Specimen collected by swabs, and then cultured on blood agar, MacConkey agar. The plates were incubated overnight at 37 0 c, Virendra S Kolhe et al. Antibiotic Resistance Pattern in Aerobic Gram Negative Bacterial Infection in Burn Patient’s at Tertiary Care Hospital in Maharashtra International Journal of Research & Review (www.gkpublication.in) 106 Vol.4; Issue: 5; May 2017 aerobically. On the following morning, colony morphology was observed. Smears were made from colonies on both agar plates and stained by Gram’s staining. The isolates were identified by conventional methods. [6] After identification, antibiotic sensitivity testing was done by modified Kirby Bauer method. [7] Antibiotics used piperacillin (100ug), piperacillin tazobactam (100/10ug), gentamicin (10ug), amikacin (30ug), Cefepime (30ug), cefotaxime (30ug), imipenem (10ug), ciprofloxacin (5ug), co-trimoxazole(25ug), ampicillin (10ug), ceftazidime(30ug). RESULTS Out of 277 patients, there were 105 (37.90%) male patients and 172 (62.10%) female patients. The most commonly affecting age groups among male patients were 31-50 years and among female patients were 16-30 years. There is correlation between age and gender, P value < 0.0001, which is highly significant. 246 (88.80%) patients were of thermal burn and followed by scalding 22 (7.9%) and electrical burn 9 (3.2%). Single microorganism was isolated in 210 (59.49%) wound swabs, while more than one organism was isolated in 84 (23.79%) wound swabs. Sterile lesions were found in 59 (16.71%) wound swabs. Among the 384 isolate Gram negative organisms causing infection were more 289 (75.26%). Table-I : Showing various Gram negative organisms isolated