Common pathogens isolated from burn wounds and their antibiotic resistance patterns

Abstract

Objective: Burn wound infections are the most severe cause of mortality in patients in the burn units. The aim of this study is to determine the bacteriological profile and their antibiotic resistance patterns in burn unit of Dicle University Hospital. Methods: Medical records of 151 burn patients admitted to the burn unit of Dicle University Hospital between June, 2008 and June 2010 were reviewed retrospectively. Results: Our study included 70.2% (n=106) male and 29.8% (n=45) female patients. The mean age of cases was 10.9±14.7 years. The rate of isolated microorganisms were 62.3% (n=94) Acinetobacter baumannii, 25.8% (n=39) Pseudomonas aeruginosa, 7.3% (n=11) Escherichia coli and 4.6% (n=7) Staphylococcus aureus. The most effective antibiotic against A. baumannii was colistin (95%) followed by levofloxacin (84%) and trimethoprim-sulfamethoxazole (87%). The most effective antibiotics against P. aeruginosa were amikacin (82%), ciprofloxacin (71%) and levofloxacin (71%). The most effective antibiotics against E. coli were amikacin (91%), meropenem (73%) and imipenem (82%). Conclusion: The prevalence of burn wound infection caused by A. baumannii and multiple drug resistant A. baumannii are increasing worldwide by time. The prevalence of multiple drug resistant P. aeruginosa and E. coli are rising also. So, new strategies of infection prevention should improve as soon as possible.

Keywords

• Burn units, wound infection, multiple drug resistance, antibiotics, Acinetobacter baumannii, Pseudomonas aeruginosa

Yanık yaralarından izole edilen patojenler ve antibiyotik direnç durumları

Abstract

Amaç: Yanık yara enfeksiyonları yanık ünitelerindeki hastaların en sık ölüm nedenleridir. Amacımız Dicle Üniversitesi Hastanesi yanık ünitesindeki bakteri profilini ve antibiyotik direnç paternlerini belirlemekti. Yöntemler: Dicle Üniversitesi Hastanesi yanık ünitesinde Haziran 2008 ve Haziran 2010 tarihleri arasında yatarak takip edilen 151 hastanın dosyaları geriye dönük olarak incelendi. Bulgular: Çalışmamız 106 (%70,2) erkek ve 45 (%29,8) kadın hastadan oluşuyordu. Olguların yaş ortalaması 10.9±14.7 yıl olarak bulundu. İzole edilen mikroorganizmalar; %62,3 (n=94) Acinetobacter baumannii, %25,8 (n=39) Pseudomonas aeruginosa, %7,3 (n=11) Escherichia coli and %4,6 (n=7) Staphylococcus aureus olarak saptandı. A. baumannii\'ye karşı en etkili antibiyotik kolistin idi, ikinci sırada levofloksasin (%84) ve üçüncü sırada trimethoprim-sülfametoksazol (%87) takip ediyordu. P. aeruginosa\'ya karşı en etkili antibiyotikler; amikasin (%82), siprofloksasin (%71) ve levofloksasin (%71) idi. E. coli\'ye karşı en etkili antibiyotikler ise amikasin (%91), meropenem (%73) ve imipenem (%82) idi. Sonuç: A. baumannii nedeniyle oluşan yanık yara enfeksiyonları ve çoklu ilaç direncine sahip A. baumannii\'nin yaygınlığı dünyada giderek artmaktadır. Çoklu ilaç direncine sahip P. aeruginosa ve E. coli patojenleri de artmaktadır. Bu nedenle en kısa zamanda yeni enfeksiyon önleme stratejileri geliştirilmelidir.

Keywords

• Yanık üniteleri, yara enfeksiyonu, çoklu ilaç direnci, antibiyotikler, Acinetobacter baumannii, Pseudomonas aeruginosa

References

1. Manson WL, Pernot PC, Fidler V, et al. Colonisation of burns and the duration of hospital stay of severely burned patients. J Hospital Infect 1992;22:55-63.
2. Tekin R, Yolbas I, Selcuk CT, et al. An evaluation of pedi- atric burn patients over a 15-year period. Turk J Trauma & Emergency Surg 2012;18:514-518.
3. Revathi G, Puri J, Jain BK. Bacteriology of burns. Burns 1998;24:347-349.
4. Davis SC, Pisanni F, Montero RB. Effects of commonly used topical antimicrobial agents on Acinetobacter baumannii: an in vitro study. Mil Med 2008;173:74-78.
5. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538-582.
6. Tredget EE, Shankowsky HA, Rennie R, et al. Pseudo- monas infections in the thermally injured patient. Burns 2004;30:3-26.
7. Sengupta S, Kumar P, Ciraj AM, Shivananda PG. Acineto- bacter baumannii-an emerging nosocomial pathogen in the burns unit Manipal, India. Burns 2001;27:140-144.
8. Ananthakrishnan AN, Kanungo R, Kumar K, Badrinath S. Detection of extended spectrum beta lactamase producers among surgical wound infections and burns patients in JIP- MER. Ind J Med Microbiol 2002;18:160-165.

9. Greenhalgh DG, Saffle JR, Holmes JH, et al. American Burn Association consensus conference to define sepsis and in- fection in burns. J Burn Care Res 2007;28:776-790.
10. Ekrami A, Kalantar E. Bacterial infections in burn patients at a burn hospital in Iran. Indian J Med Res 2007;126:541- 544.
11. Frame JD, Kangesu L, Malik WM. Changing flora in burn and trauma units: experience in United Kingdom. J Burn Care Rehabil 1992;13:281-286.
12. Amin M, Kalantar E. Bacteriological monitoring of hospital borne septicemia in burn patients in Ahvaz, İran. Burn Sur- gical Wound Care 2004;3:4-8.
13. Nasser S, Mabrouk A, Maher A. Colonization of burn wounds in Ain Shams University Burn Unit. Burns 2003;29:229-233.
14. Singh NP, Goyal R, Manchanda V, et al. Changing trends in bacteriology of burns in the burns unit, Delhi, İndia. Burns 2003;29:129-132.
15. Revathi G, Puri J, Jain BK. Bacteriology of burns. Burns 1998;24:347-349.
16. Erol S, Altoparlak U, Akcay MN, et al. Changes of micro- bial flora and wound colonization in burned patients. Burns 2004;30:357-361.
17. Aksaray S, Cesur S. Microorganisms isolated from wound and blood culture of burn patients and their antibiotic sus- ceptibility. Turkish J İnfect 2003;17:293-296.
18. Babik J, Bodnarova L, Sopko K. Acinetobacter-serious dan- ger for burn patients. Acta Chir Plast 2008;50:27-32.
19. Rezaei E, Safari H, Naderinasab M, Aliakbarian H. Com- mon pathogens in burn wound and changes in their drug sensitivity. Burns 2011;37:805-807.
20. Albrecht MC, Griffith ME, Murray CK, et al. Impact of Aci- netobacter infection on the mortality of burn patients. J Am Coll Surg 2006;203:546-550.