Time Related Changes in Bacteriological Profile of Burn Wound and their Antibiogram

Abstract

A prospective study of the burn cases were carried out in 42 burn patients admitted in burn unit of Bir Hospital from September 2011 to Feburary 2012 to evaluate time-related changes in aerobic bacterial colonization and their sensitivity pattern. Periodic swabs were taken from the burn wound on 1st, 2nd, 3rd, and 4th weeks to see the changing pattern of organisms during hospital stay of patients. The antibiotic susceptibility tests of identified bacteria were done by Kirby-Bauer disk diffusion techniques. In the present study burn injury was found to be highest in the age group 25-34 years (28.6%). Male to female ratio was 1:1.5. Fire was the major cause of burn (78.6%) followed by scald burn (7.1%). Among the 168 samples, single organism was isolated in 47.6% samples and mixed organisms in 39.9% and no growth in 12.5%. A total of 215 bacterial isolates were isolated from 168 samples in which Pseudomonas aeruginosa accounts for the highest percentage 45.6% followed by Staphylococcus aureus (19.1%), Acinetobacter spp. (17.7%) and CONS (5.6%). On 1st week of culture 38.6% of the isolates were P. aeruginosa followed by Acinetobacter spp. (21%) and S. aureus (19.2%). No growth was found in 14.3% samples. These findings were gradually changing with time and on 4th week P. aeruginosa were 57.8% whereas S. aureus and Acinetobacter spp. were only 13.3% each respectively. Antimicrobial sensitivity test showed that P. aeruginosa was highly resistant to antimicrobial agents. It was most sensitive to polymyxine B (99%) followed by amikacin (64.3%). Acinetobacter spp. was found least resistant to amikacin (28.9%) followed by chloramphenicol (36.8%). S. aureus was least resistant to vancomycin (2.4%) followed by levofloxacin (19.5%) and chloramphenicol (19.5%) whereas they were moderately resistant to oxacillin (53.7%). Continuous survey and analysis of changing microbial flora and their antibiogram in burn patients help in timely detection and control of spread of infection and also help to review effective antibiotic policies.