Prevalence Of Various Bacteria And Their Antibiotic Sensitivity Pattern In Burn Unit Of Government Medical College And Hospital Srinagar

摘要

Background:There is high incidence of infections and septicemias in post burn patients which in turn are associated with high morbidity and mortality; is true in our burn unit too, a fact which activated us to undertake this study.Purpose:We conducted a prospective study with the aimtodetermine specific pattern of burn wound microbial colonization, time related changes in predominant flora, and antimicrobial resistance profiles. This would allow early management of septic episodes with proper empirical systemic antibiotics before the results of microbiologic cultures become available, thus improving the overall infection related morbidity and mortality.Material and methods:This prospective study was conducted from 1stApril 2010 to 31stMarch 2011 in the Department of Surgery Government Medical College in collaboration with the Department of Microbiology on 100 Burn patients who fulfilled the standard criteria for admission in our burn unit. 10 ml of blood was drawn under all aseptic precautions in blood culture vial after 48 hr of admission and transported to the microbiology lab and then systemic antibiotics were given. In laboratory the blood sample were processed as per the standard microbiological procedure and protocols. First the culture bottles were incubated at 35 degree Celsius and observed for evidence of any growth in first 6 to 18 hours after collection, then blood subculture to Macconky agar and blood agar were made from all blood culture bottles and further incubated for 48 hours. Samples which did not show any growth at 48 hours of incubation were declared culture negative. The positive blood cultures were subjected to antibiotic susceptibility test. The data obtained was analyzed by using appropriate Statistical analytical tests.Results:The commonest organism responsible for bacteremia is pseudomonas (42%) followed by MRSA methicillin resistant staphylococcus aureus (28.9% ). Most of the strains of organisms isolated were resistant to commonly used antibiotics in the hospital, pseudomonas was found 100% resistant to combination of ampicillin+ sulbactum, ceftriaxone, and was sensitive to imipenem, amikacin, and vancomycin in 89.47%, 57%, 52,63% cases respectively. MRSA (methicillin resistant staph aureus) was also found resistant to commonly used antibiotics like ceftriaxone, ampicillin + sulbactum, ceftazidime + calvulanic acid. Linzolid and vancomycin were effective in 84% and 100% cases respectively. A significant correlation of TBSA Burnt with bacteremia (p value of <.001) was observed.Conclusion:Weconcluded that our study will be helpful in providing useful guidelines for choosing effective empirical therapy which will have great impact on morbidity and mortality of burn patients due to bacteremia / septicemia. Introduction Most of the burn victims, who survive including the initial 24 hours after burns, succumb to infection of the burnt area and its complications1. Various factors responsible are disruption of the skin barrier, a large cutaneous bacterial load, the possibility of the normal bacterial flora becoming opportunistic pathogens and severe depression of the immune system, all contribute towards the sepsis in a burn victim2. Despite various advances in infection control measures, like early detection of micro organisms and newer and broader spectrum antibiotics, management of burn septicemia still remains a big challenge and septicemia continues to be the leading cause of death in burn patients.3In spite of considerable advances in the treatment of burns, infection continues to pose the greatest danger to burn patients4,5. Approximately 73 per cent of all death within the first five days post-burn have been shown to be directly or indirectly caused by septic processes.6The common pathogens isolated from burn patients include Pseudomonas aeruginosa, Staphylococcus aureus, Klebsillea spp, and various coliform bacilli. Fungi (Candida albicans, Aspergillus fumigatus) can also cause infection.7-11Multid