Longitudinal Bacteriology of Burn Patients at Yekatit 12 Hospital Burn Center, Addis Ababa, Ethiopia.
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Date
2011-04
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Addis Ababa University
Abstract
Introduction: Burn is one of the most common, devastating and a very painful form of trauma.Significantburn injuries induce a state of immunosuppression that predisposes burn patients toinfectious complications. Sepsis and the resultant multi-organ failure are the leading causes ofdeath in intensive burn care units. Rapidly emerging nosocomial and community acquiredpathogens and the problem of multidrug resistance necessitates periodic review of isolationoutline and their antibiotic susceptibility pattern in burn centers.Objective:Theaim of this study was to determine longitudinal bacteriology of burn patients atY ekatit 12 hospital burn center, Addis Ababa.
Methods and materials: A prospective hospital based study was carried out from Dec 2010 toFeb 2011.Wound swab and blood samples were collected on 0,7th,and 14th, days of hospital stay and processed by conventional culture and biochemical identification procedures. Onceidentified, isolates were tested against commonly used antibiotics in the hospital by Modified Kirby-Bauerdisc diffusion method. Data was analyzed by SPSS version 17.0for Windows.
Results: Forty onepatients were enrolled in the study from both burn unit (BU) and outpatient(OPD). The mean total burned surface area (TBSA) was 11.9%. From 104 pus cultures 101isolates were identified during the study period. In the first pus culture S. aureus was predominated, 15(46.9%) but later on Pseudomonas spp was increasing. Both spp together accounted 87.1% of the total isolates. Regarding blood culture isolates there was no significant change on time.Of 92 blood cultures 15 gram positive isolates were recognized. Coagulasenegative Staphylococci (CoNS) noted with the largest percentage, 8 (53.3%) followed by S.aureus6 (40%).Staphylococcus aureusshowed moderate degree of resistance to the commonly used antibiotics. Majority of isolates were susceptible for clindamycin and vancomycin. But Pseudomonasspp were resistant for most of antibiotics used in the hospital. However, it was found more sensitive to norfloxacineas it was evidenced by only 15% resistance.
Conclusion: Every treatment facility has microorganisms unique to it and these might change with time. It is therefore of paramount importance to have an in-depth knowledge of the resident organisms and their antibiotic sensitivity pattern so that infection related morbidity and mortality will improved. The nature of microbial wound colonization and flora changes should be taken into consideration in empirical antimicrobial therapy of burned patients.
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Keywords
Burn, Sepsis, Time related bacterial colonization, Antibiotic resistance