HOSPITAL-ACQUIRED MRSA SEPSIS IN BURN CARE UNIT OF A TERTIARY CARE CENTER IN NORTH INDIA.
Authors: Majid Iqra , Nahvi Nahid , Rishi Saqib , Dewani Safura 
Published: January 2022

INTRODUCTION: Bloodstream infection and the subsequent development of sepsis are among the most common infection complications
occurring in burn patients. Hospital-Acquired transmission of microorganisms are associated with the emergence of antimicrobial resistance
among a variety of bacterial and fungal burn wound pathogens which limits the therapeutic options for the treatment of infections associated with
burns. Over the last several decades, antibiotic resistant organisms have resulted in increased mortality in burns patients. MATERIAL AND
METHODS: This prospective study was conducted in the Department of Microbiology, Government Medical College, over a period of 1 year The
patients admitted to burn care unit with the following criteria were included in the study: No infection at the time of admission and up to 48 hrs
(cultures negative); Length of stay in the hospital more than 48 hrs; Signs and symptoms suggestive of infection. Patients referred from other
hospitals were excluded. Samples from patients falling under the inclusion criteria of the study and manifesting any symptoms and signs of
Hospital-Acquired infection during the management of burns were included in the study H. ospital-Acquired infections were dened based on CDC
criteria as described below: Blood samples for culture were collected from patients with burn wounds showing signs of infection as dened by
CDC. Positive Isolates were conrmed by conventional biochemical tests. Isolates exhibiting ambiguous taxonomic classication were conrmed
by Vitek-2 Compact Automated Identication System following the manufacturer's instructions. Antimicrobial susceptibility testing were
performed using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI). OBSERVATIONS
AND RESULTS: A total 71 patients developed Hospital-Acquired infections out of these 20 % developed blood stream infection. Most common
age group in our study was between 31-40 years (33.80%) Most frequent organisms isolated from blood culture were MRSA (20%) followed by
pseudomonas aeruginosa (15%) and Acinetobacter spp (10%).Candida spp was isolated from 10% of cultures. All isolates of stayphlococcus
aureus were Methicillin resistant however all ve isolates were sensitive to vancomycin, clindamycin and linezolid. All isolates of Pseudomonas
were sensitive to polymyxin-b,while as 33% were sensitive to Gentamicin. All isolates of Acinetobacter were sensitive to Gentamicin and
Tobramycin while as only 50% were sensitive to Ooxacin. Further burn units are CONCLUSION: ideal for outbreaks of MDR pathogens which
can affect other patients, so adequate infection control measures need to be in place. Culture and antimicrobial susceptibility testing should be
performed routinely, including MRSA and ESBL screening, whenever burn wound and blood stream infections are suspected. Antimicrobial
sensitivity test results should be used to guide the choice of antibiotics. Also we need to conduct molecular studies on the isolates to determine their
resistance genes and strains typing to determine which strains are implicated in these hospital acquired infections.