The Microbial Profile and Antibiotic Susceptibility in Burn Wound Infection: A Hospital Based Study

Aim: To determine spectrum of bacteria infecting burn wound and its antibiotic susceptibility at Benue State University Teaching Hospital (BSUTH). Study Design: A one year prospective study of the microbial profile in burn wound infection at BSUTH, Makurdi. Methodology: All patients admitted from August 2018 to July 2019 with burn wound who had wound swab microscopy culture and sensitivity (MCS) after thorough cleaning of the wound were included in the study. Data collected included the Age, Sex, Occupation, Total Body Surface Area (TBSA) of burn, injuring agent, type of burn, bacteria cultured from the wound, antibiotic susceptibility, number of days of admission and outcome of treatment. Results: Out of the 63 patients admitted, flame was the predominant injuring agent seen in 54 (85.7%) patients. The age group 21 – 30 years was the most affected, 27 constituting 42.9%. Burn wound infection occurred in 25(39.7%) patients from whom 33 bacterial isolates were recovered. Gram negative organisms Pseudomonas species and Proteus species were the commonest bacteria isolated constituting 21.21% each. Other isolates were Staphylococcus aurous 36.36%, Escherichia coli 15.15%, Klebsiella species and Staphylococcus saprophyticus (each 3.03%,). There was multiple bacteria colonization of wounds and antibiotics resistance. There was no gender difference in the burn wound infection, P =0.7819. Conclusion: The sensitivity pattern showed many of the bacteria to be resistant to commonly administered antibiotics but sensitivity patterns got are important for empirical antibiotics prescription when patients come with glaring sepsis and are waiting for wound swab microscopy culture and sensitivity. Studying the microbial profile with antibiotic resistance pattern in burn’s wound infection should be a continuous process in all burn units/departments. This will help to formulate and modify at regular intervals, a hospital/departmental antibiotic policy according to the present microbial pattern in the respective burns unit.

Download Full-text

Bacteriological profile with antibiotic sensitivity pattern of burn wound infections in a peripheral tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20211307 ◽

2021 ◽

Vol 8 (4) ◽

pp. 1253

Author(s):

Arnab Mandal ◽

Swapan Das

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Susceptibility ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Specific Pattern ◽

Care Hospital ◽

Wound Infections ◽

Burn Wound ◽

Mortality And Morbidity ◽

Sensitivity Pattern

Background: India, has an estimated burn incidence of 6-7 million annually. Nearly 10% of these are life threatening and require hospitalization, and main cause of mortality and morbidity of these burn patients were wound infection and sepsis after 1st 24 hours. The present study was tried to determine specific pattern of burn wound infections, and antibiotic susceptibility of those isolates.Methods: After matching inclusion and exclusion criteria, total 55 patients were taken for this institution based, prospective observational study. Wound swabs were collected on day 7 and cultured aerobically in MacConkey agar and 5% blood agar and antibiotic susceptibility testing was done on Muller Hinton agar using Kirby-Bauer disc diffusion method.Results: Among study population 69.1% patients were female and majority (29.1%) of the patients belongs to age group from 21 to 30. It was found that 48 wound swabs were positive for microorganisms, of which Pseudomonas aeruginosa was most common isolated organism (23.6%), followed by Klebsiella pneumoniae (16.4%) and Staphylococcus aureus (14.5%). The most effective antibiotic found in this study was piperacillin/tazobactam, followed by imipenem/cilastatin.Conclusions: It was seen that gram-negative organisms were more prevalent. Pseudomonas aeruginosa was the most common microorganism and piperacillin/tazobactam was most effective antibiotic.

Download Full-text

Study on Time-related Changes in Aerobic Bacterial Pattern of Burn Wound Infection

Faridpur Medical College Journal ◽

10.3329/fmcj.v6i1.7410 ◽

1970 ◽

Vol 6 (1) ◽

pp. 41-45 ◽

Cited By ~ 2

Author(s):

SK Saha ◽

N Muazzam ◽

SA Begum ◽

A Chowdhury ◽

MS Islam ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Hospital Stay ◽

Bacterial Colonization ◽

Total Body Surface Area ◽

Burn Wound ◽

Female Ratio ◽

E Coli ◽

Antimicrobial Sensitivity ◽

Sensitivity Pattern

A prospective study was carried out in 50 burn patients admitted in Burn unit of Dhaka Medical College Hospital over a period of one year from January 2005 to December 2005 to evaluate time-related changes in aerobic bacterial colonization and their sensitivity pattern. Periodic swabs were taken from the burn wound on Day 0, Day 7, Day 14 and Day 21 to see the changing pattern of organisms during hospital stay of patients. In the present study burn injury was highest in the age group 11-20 yrs (34%). Male to female ratio was 1.38:1. The mean percentage of burn was 35.79% of total body surface area (TBSA). Fire was the major cause of burn (38%) followed by electric burn (20%). Among the 200 samples, single organism was isolated in 71% samples and mixed organism in 13.5% and no growth in 14.5%. Among single isolates Pseudomonas aeruginosa was leading (28%) followed by Escherichia coli (17.5%), Staphylococcus aureus (16%), coagulse negative Staphylococcus (4.5%) and Klebsiella (2%). Among mixed growth Pseudomonas aeruginosa was still leading (11%) follow by E. coli (9.5%) Staphylococcus (5.5%), Proteus (1%) and Klebsiella (0.5%).There were time -related changes in bacterial isolation from burn wound during hospital stay of patients. On admission 42% of the isolated organisms were Staphylococcus aureus and only 6% each Pseudomonas aerunginosa and E. coli were isolated. No growth was found in 28%. samples. These findings were gradually changing with time and on day 21 Staphylococcus aureus were only 4% whereas Pseudomonas aeruginosa were 40% and E. coli 28%. Antimicrobial sensitivity test showed that pseudomonas aeruginosa was highly resistant to antimicrobial agents. It was most sensitive to Imipenem (98.72%) followed by Aztreonam (33.44%), Ceftazidime (38.32%) and Gentamicin (19.23%). E. coli was also found most sensitive to Imipenem (98.15%) followed by Gentamicin (38.95%), Chloramphenicol (37.1%), Ciprofloxacin (35.25%) and ceftraixone (29.70%). Staphylococcus aureus was 100% sensitive to Vancomycin followed by Amoxiclav and Oxacillin (53.43% each), Gentamicin (44.70%) and Cloxacillin (39.52%). It is crucial for every burn institution to determine the specific pattern of burn wound microbial colonization, the time-related changes in dominant flora, and the antimicrobial sensitivity profiles. This would enable early treatment of septic episodes with proper empirical systemic antibiotics without waiting for culture results, thus improving overall infection related morbidity and mortality. DOI: 10.3329/fmcj.v6i1.7410 Faridpur Med. Coll. J. 2011;6(1): 41-45

Download Full-text

Current Microbial Isolates from Wound Swab and Their Susceptibility Pattern in a Private Medical College Hospital in Dhaka city

Delta Medical College Journal ◽

10.3329/dmcj.v3i1.22236 ◽

2015 ◽

Vol 3 (1) ◽

pp. 25-30 ◽

Cited By ~ 1

Author(s):

Shahin Sultana ◽

Nurunnahar Mawla ◽

Shamima Kawser ◽

Nayareen Akhtar ◽

Md Khoybar Ali

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Wound Infection ◽

Antimicrobial Susceptibility ◽

Clinical Laboratory ◽

Diffusion Method ◽

College Hospital ◽

Medical College ◽

Wound Swab ◽

Sensitivity Pattern

Background: Wound infection is one of the major health problems that are caused and aggravated by the invasion of pathogenic organisms where empiric treatment is routine. Objective: To isolate and identify the bacteria causing wound infection and to determine the antimicrobial susceptibility pattern.Materials and method: A total of 263 wound swab and pus samples were collected during the period of January to December 2012 from Delta Medical College and Hospital, Dhaka, Bangladesh. Swabs from the wound were inoculated on appropriate media and cultured and the isolates were identified by standard procedures as needed. Antimicrobial susceptibility testing was performed by disk diffusion method according to The Clinical Laboratory Standard Institute guidelines. Results: In this study 220 bacterial isolates were recovered from 263 samples showing an isolation rate of 83.65%. The predominant bacteria isolated from infected wounds were Staphylococcus aureus 89 (40.45%) followed by Escherichia coli 62 (28.18%), Pseudomonas aeruginosa 34 (15.45%), Enterococci 18 (8.18%), Acinetobacter 5 (2.27%), Klebsiella 9 (4.09%) and Proteus 3 (3.36%). Staphylococcus aureus was sensitive to linezolid (94.38%), fusidic acid (91.01%), vancomycin (87.64%), amikacin (74.15%) and gentamicin (73.03%). Among the Gram negative isolates Escherichia coli was predominant and showed sensitivity to imipenem (93.54%) amikacin (83.87%) colistin (53.22%) and piperacillin and tazobactum (53.22%) and pseudomonas showed sensitivity to amikacin (73.52%), imipenem (70.58%) and colistin (70.58%). Conclusion: Staphylococcus aureus was the most frequently isolated pathogen from wound swab and the antibiotic sensitivity pattern of various isolates help to assist the clinician in appropriate selection of empirical antibiotics against wound infection. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22236 Delta Med Col J. Jan 2015; 3(1): 25-30

Download Full-text

ESBL producing Gram Negative Aerobic Bacteria Isolated from Burn Wound Infection with Their Antibiogram in Dhaka

Journal of Science Foundation ◽

10.3329/jsf.v10i2.17959 ◽

2014 ◽

Vol 10 (2) ◽

pp. 63-69 ◽

Cited By ~ 1

Author(s):

MS Islam ◽

M Abdullah Yusuf ◽

M Shah Jahirul Hoque Chowdhury ◽

M Afzal Hossain

Keyword(s):

Wound Infection ◽

Multi Drug Resistance ◽

Periodic Review ◽

Burn Wound ◽

Esbl Producer ◽

College Hospital ◽

Klebsiella Species ◽

E Coli ◽

Medical College ◽

Sensitivity Pattern

Background: Infection is an important cause of mortality in burns. Rapidly emerging nosocomial pathogens and the problem of multi-drug resistance necessitates periodic review of isolation patterns and antibiogram in the burn ward. Objective: The purpose of the present study was to see the frequency of bacteria in burn wound with their antibiotic sensitivity pattern. Method: This cross sectional study was conducted in the laboratory of Department of Microbiology at Dhaka Medical College, Dhaka and samples were collected from the burn unit of Dhaka Medical College Hospital, Dhaka. Bacterial isolates from 108 wound swabs taken from burn patients were identified by conventional biochemical methods and antimicrobial susceptibility was performed. Result: Out of 98 bacteria E. coli (20.4%) was most common and 25.0% of these bacteria were ESBL producer. Out of 14 Klebsiella species ESBL producer was in 6(42.9%). ESBL producing Proteus species (21.4%) and Pseudomonas species (14.9%) were also detected. Klebsiella (33.91%) was the predominant organism closely followed by Pseudomonas (31.84%). Conclusion: E. coli is the most common ESBL producing bacteria causing the burn wound infection. DOI: http://dx.doi.org/10.3329/jsf.v10i2.17959 J Sci Found, 2012;10(2):63-69

Download Full-text

Antibiotic susceptibility patterns of bacterial isolates in burn wound infection in a tertiary care hospital

Journal of International Medicine and Dentistry ◽

10.18320/jimd/201704.0395 ◽

2018 ◽

Vol 4 (3) ◽

pp. 95-104

Author(s):

Keerthi S ◽

◽

Binoy Kurian ◽

Sathiavathy K A

Keyword(s):

Wound Infection ◽

Antibiotic Susceptibility ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Bacterial Isolates ◽

Burn Wound ◽

Antibiotic Susceptibility Patterns ◽

Susceptibility Patterns

Download Full-text

531 The Effect of Burn Wound Size on Caloric Requirements: A Correlation of Nutritional Changes to the Clinical State

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.181 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S113-S114

Author(s):

Marc R Matthews ◽

Sara Calder ◽

Areta Kowal-Vern ◽

Philomene Spadafore ◽

Karen J Richey ◽

...

Keyword(s):

Injury Severity ◽

Burn Injury ◽

Recovery Period ◽

Total Body Surface Area ◽

Caloric Intake ◽

Retrospective Chart Review ◽

Clinical State ◽

Apache Score ◽

Burn Wound ◽

Caloric Requirements

Abstract Introduction Caloric intake has been a vital component for burn wound healing and recovery. The hypothesis was that caloric requirements are based on injury severity & post-burn week as predicated by indirect calorimetry (IC)/predictive equations. Methods This was a retrospective chart review of 115 burn patients (2012–2017). Caloric requirements were determined by the Curreri equation [which includes % total body surface area (TBSA)] and IC for a 5-week period provided mainly by enteral nutrition. Patients received supplements and total parenteral nutrition as needed. Results The mean ±sd age was 43±18 years, 41±18 % TBSA, Body Mass Index of 28±7 kg/m2, and mortality of 26 (23%). The major mechanisms of injury were flame/flash/explosions. There were 59 (51%) of patients with < 40 % TBSA burns, [median Injury Severity Score (ISS) 9; Apache score 14], and 56 (49%) with ≥40 % TBSA (median ISS 25; Apache score 21), p < .0001. The Respiratory Quotient (RQ) had a median of 0.94 (range 0.79 to 1.02). The median number of surgeries for the < 40 % TBSA group was 5 versus 12 for the ≥40 % TBSA, p < .0001. The Injury Factor did not differ from weeks 1–5 (1.8 for < 40 % TBSA and 2.0 for the ≥ 40 % TBSA). The Curreri equation calculation for this study was a median 3640 (range 2161–5950) calories. The Curreri equation resulted in significantly increased caloric recommendations for the ≥ 40 %TBSA compared to the < 40 %TBSA patients, p < .0001. The < 40 %TBSA group had caloric requirements ranging between 1500- 2700 calories compared to the ≥ 40 %TBSA group, whose calories ranged between 2000–3700. The total daily caloric recommendations were also significantly increased in the ≥40 %TBSA compared to the < 40 %TBSA patients. The maximum levels of resting energy expenditure (REE) from IC, total daily calories recommended by the dietitian and average calories ranged between 3000–4500 in the < 40 %TBSA group and 3600–6700 in the ≥ 40 %TBSA group. The caloric recommendations increased for all patients from week 1 to week 3 and leveled off during weeks 4–5. Conclusions Patient caloric requirements were dependent not only on the severity of the burn injury but also the post-burn hospitalization during which surgeries, debridement/grafting, and infectious complications occurred. They increased until the third week post-burn and leveled off in the recovery period. The study caloric recommendations and requirements were consistent with the REE and Curreri equation assessments.

Download Full-text

674 Machine Learning and Automation in Burn Care: A Systematic Review

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.320 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S193-S193

Author(s):

Samantha Huang ◽

Justin Dang ◽

Clifford C Sheckter ◽

Haig A Yenikomshian ◽

Justin Gillenwater

Keyword(s):

Machine Learning ◽

Systematic Review ◽

Total Body Surface Area ◽

Burn Wound ◽

Burn Care ◽

Surgeon Experience ◽

Automated Software ◽

Burn Depth ◽

Automated Methods ◽

Equal Weighting

Abstract Introduction Current methods of burn evaluation and treatment are subjective and dependent on surgeon experience, with high rates of inter-rater variability leading to inaccurate diagnoses and treatment. Machine learning (ML) and automated methods are being used to develop more objective and accurate methods for burn diagnosis and triage. Defined as a subfield of artificial intelligence that applies algorithms capable of knowledge acquisition, machine learning draws patterns from data, which it can then apply to clinically relevant tasks. This technology has the potential to improve burn management by quantitating diagnoses, improving diagnostic accuracy, and increasing access to burn care. The aim of this systematic review is to summarize the literature regarding machine learning and automated methods for burn wound evaluation and treatment. Methods A systematic review of articles available on PubMed and MEDLINE (OVID) was performed. Keywords used in the search process included burns, machine learning, deep learning, burn classification technology, and mobile applications. Reviews, case reports, and opinion papers were excluded. Data were extracted on study design, study objectives, study models, devices used to capture data, machine learning, or automated software used, expertise level and number of evaluators, and ML accuracy of burn wound evaluation. Results The search identified 592 unique titles. After screening, 35 relevant articles were identified for systematic review. Nine studies used machine learning and automated software to estimate percent total body surface area (%TBSA) burned, 4 calculated fluid requirements, 18 estimated burn depth, 5 estimated need for surgery, 6 predicted mortality, and 2 evaluated scarring in burn patients. Devices used to estimate %TBSA burned showed an accuracy comparable to or better than traditional methods. Burn depth estimation sensitivities resulted in unweighted means >81%, which increased to >83% with equal weighting applied. Mortality prediction sensitivity had an unweighted mean of 96.75%, which increased to 99.35% with equal weighting. Conclusions Machine learning and automated technology are promising tools that provide objective and accurate measures of evaluating burn wounds. Existing methods address the key steps in burn care management; however, existing data reporting on their robustness remain in the early stages. Further resources should be dedicated to leveraging this technology to improve outcomes in burn care.

Download Full-text