FREQUENCY AND ANTIMICROBIAL SUSCEPTIBILITY OF BACTERIA ISOLATED FROM BURN WOUNDS: A THREE YEARS ANALYSIS AT BURNS AND PLASTIC SURGERY CENTER, PESHAWAR

Main Article Content

Zubeda Irshad
Tahmeedullah
Rabbia Mahboob

Abstract

Objectives: To determine the frequency of bacteria isolated from burn wounds, and their percent susceptibilities against a panel of antibiotics by analyzing burn wound culture, and susceptibility test results data of the patients managed in our burn center over a period of three years.
Methodology: In this descriptive, observational, cross-sectional, study a summary of antibiotic susceptibilities of isolated bacteria to tested antibiotics in percentages was prepared to assess the susceptibility pattern of bacteria. The prevalence of each of the isolated specie and genus of bacteria was determined. For susceptibility testing and antibiogram construction, the guide lines of Clinical and Laboratory Standards Institute (CLSI), Performance Standards for Antimicrobial Susceptibility Testing. 30th ed. Supplement M100, and Analysis and Presentation of
Cumulative Antimicrobial Susceptibility Test Data; Approved Guideline—5th Edition: M39-2022 were followed. Excel and SPSS 24 were used for data entry and calculation of percentages and frequencies.
Results: Gram-negative bacteria were more commonly isolated as compared to gram-positive bacteria. Out of total 5166 isolated bacteria, 4334 (83.89 %) of isolates were gram-negative, whereas 832 (16 .11%) were gram-positive. The most commonly isolated bacteria were Klebsiella pneumoniae (K. pneumoniae) with 1095 (21.20%), followed by Pseudomonas aeruginosa (P. aeruginosa) with 989 (19.16%) occurrences and gram-positive cocci, respectively.
Conclusions: It is clear from our results that Gram-negative bacteria were more commonly involved in burn wound infection at our center. In addition, the isolated organisms had shown resistance to co-amoxiclav and cephalosporins and several other tested antibiotics.

Article Details

How to Cite
1.
Irshad Z, Tahmeedullah, Mahboob R. FREQUENCY AND ANTIMICROBIAL SUSCEPTIBILITY OF BACTERIA ISOLATED FROM BURN WOUNDS: A THREE YEARS ANALYSIS AT BURNS AND PLASTIC SURGERY CENTER, PESHAWAR. J Postgrad Med Inst [Internet]. 2024 May 8 [cited 2024 May 26];38(2):117-24. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/3350
Section
Original Article

References

Yakupu A, Zhang J, Dong W, Song F, Dong J, Lu S. The epidemiological characteristic and trends of burns globally. BMC Public Health. 2022;22(1):1596. DOI: 0.1186/s12889-022-13887-2

Hendriks, T., Botman, M., Binnerts, J., Mtui, G., Nuwass, E., Meij-de Vries, A., et al. (2022). Acute burn care in resource-limited settings: A cohort study on treatment and outcomes in a rural regional referral hospital in Tanzania. Burns, 48(8), 1966–1979. DOI: 10.1016/j.burns.2022.01.024

Tsolakidis S, Freytag DL, Dovern E, Alharbi Z, Kim BS, Houschyar KS, et al. Infections in burn patients: a retrospective view over seven years. Medicina. 2022;58(8):1066. DOI: 10.3390/medicina58081066.

Vinaik R, Barayan D, Shahrokhi S, Jeschke MG. Management and prevention of drug resistant infections in burn patients. Expert Rev Anti Infect Ther. 2019;17(8):607–19. DOI: 10.1080/14787210.2019.1648208.

Ruegsegger L, Xiao J, Naziripour A, Kanumuambidi T, Brown D, Williams F, et al. Multidrug-resistant gram-negative bacteria in burn patients. Antimicrob Agents Chemother. 2022;66(9):e00688-22. DOI: 10.1128/AAC.00688-22.

Pulingam T, Parumasivam T, Gazzali AM, Sulaiman AM, Chee JY, Lakshmanan M, et al. Antimicrobial resistance: Prevalence, economic burden, mechanisms of resistance and strategies to overcome. Eur J Pharm Sci. 2022;170:106103. DOI: 10.1016/j.ejps.2022.106103.

Singh NP, Rani M, Gupta K, Sagar T, Kaur IR. Changing trends in antimicrobial susceptibility pattern of bacterial isolates in a burn unit. Burns. 2017;43(5):1083–7. DOI: 10.1016/j.burns.2017.03.002.

Hashemzadeh M, Heydari R, Asareh Zadegan Dezfuli A, Saki M, Meghdadi H, Bakhtiyariniya P. Occurrence of multiple-drug resistance bacteria and their antimicrobial resistance patterns in burn infections from southwest of Iran. J Burn Care Res. 2022;43(2):423–31. DOI: 10.1093/jbcr/irab021.

Chaudhary NA, Munawar MD, Khan MT, et al. Epidemiology, Bacteriological Profile, and Antibiotic Sensitivity Pattern of Burn Wounds in the Burn Unit of a Tertiary Care Hospital. Cureus. 2019;11(6):e4794. DOI:10.7759/cureus.4794.

Moinuddin K, Alanazi DS, Alsomali BA, Alotaibi M, Parameaswari PJ, Ali S. Prescription pattern of empirical antibiotic therapy in the burn unit of a tertiary care setting in the Kingdom of Saudi Arabia. J Pharm Bioallied Sci. 2021;13(2):188-92. DOI: 10.4103/jpbs.jpbs_382_20

Klinker KP, Hidayat LK, DeRyke CA, DePestel DD, Motyl M, Bauer KA. Antimicrobial stewardship and antibiograms: Importance of moving beyond traditional antibiograms. Ther Adv Infect Dis. 2021;8:1-9. DOI: 10.1177/20499361211011372

Kunwar A, Shrestha P, Shrestha S, Thapa S, Shrestha S, Amatya NM. Detection of biofilm formation among Pseudomonas aeruginosa isolated from burn patients. Burns Open. 2021;5(3):125–9. DOI: 10.1016/j.burnso.2020.12.005

Hemmati J, Azizi M, Asghari B, Arabestani MR. Multidrug-Resistant Pathogens in Burn Wound, Prevention, Diagnosis, and Therapeutic Approaches (Conventional Antimicrobials and Nanoparticles). Can J Infect Dis Med Microbiol. 2023; 2023. DOI: 10.1155/2023/8854311.

Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an antibiotic stewardship program: guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clin Infect Dis. 2016;62(10):e51–77. DOI: 10.1093/cid/ciw118.

Claeys KC. How to Measure the Effectiveness of Incorporating Antibiogram Data at Your Facility. Caring Ages. 2020;21(1):7. DOI: 10.1016/j.carage.2019.12.003.

Simner PJ, Hindler JA, Bhowmick T, Das S, Johnson JK, Lubers BV, et al. What’s New in Antibiograms? Updating CLSI M39 Guidance with Current Trends. J Clin Microbiol. 2022;60(10):e02210-21. DOI: 10.1128/JCM.02210-21.

Truong WR, Hidayat L, Bolaris MA, Nguyen L, Yamaki J. The antibiogram: key considerations for its development and utilization. JAC-Antimicrob Resist. 2021;3(2):dlab060. DOI: 10.1093/jacamr/dlab060.

Tenover FC. The challenge of antimicrobial resistance for the clinical laboratory: The role of the antibiogram. Med Lab Obs. 2023;55(1):8–14.

Ladhani HA, Yowler CJ, Claridge JA. Burn wound colonization, infection, and sepsis. Surg Infect. 2021;22(1):44–8. DOI: 10.1089/sur.2020.346.

Williams FN, Lee JO. Pediatric burn infection. Surg Infect. 2021;22(1):54–7. DOI: 10.1089/sur.2020.218.

Cato LD, Al-Tarrah K, Moiemen N. Changes in burn wound microbiology profile over 14 years of an adult tertiary burn center. J Burn Care Res. 2023;44(2):293–301. DOI: 0.1093/jbcr/irab184.

D’Abbondanza JA, Shahrokhi S. Burn infection and burn sepsis. Surg Infect. 2021;22(1):58–64. DOI: 10.1089/sur.2020.102.

Haque ME, Bhuiyan MAT, Sultana R, Rahman A, Das MK, Siddique NEA, et al. Different Infection Profiles and Antimicrobial Resistance Patterns between Burn Intensive Care Unit (ICU) and Common Wards. Sch J App Med Sci. 2022;11:2019–25. DOI: 10.36347/sjams.2022.v10i11.037.

Gong Y, Peng Y, Luo X, Zhang C, Shi Y, Zhang Y, et al. Different infection profiles and antimicrobial resistance patterns between burn ICU and common wards. Front Cell Infect Microbiol. 2021;11:681731. DOI: 10.3389/fcimb.2021.681731.

Joy S, D’souza RC, Surlu V, Suresh S, Jakribettu R, Baliga M. Bacteriological Profile of Pathogens in Burns Unit of a Tertiary Care Center: A Retrospective Observational Study. Wounds Compend Clin Res Pract. 2020;32(12):345–9.

Marcus JE, Chung KK, Blyth DM. Burn Wound Infection. In: Essential Burn Care for Non-Burn Specialists. Springer; 2023. p. 213–31. DOI: 10.1007/978-3-031-28898-2_9

Krishnamoorthy SG, Raj V, Viswanathan B, Dhanasekaran GP, Palaniappan D, Borra SS. Enhancing the empiric antibiotic selection by introducing an antibiogram toolkit in a tertiary care hospital in Southern India–A prospective study. J Clin Pharm Ther. 2022;47(4):507–16. DOI: 10.1111/jcpt.13571.

Tawfik AE, Hawary ATE, El Hawary A, Elhewala A, El-Sokkary RH. Analysis of cumulative antibiogram reports in intensive care units at an Egyptian University Hospital. J Infect Public Health. 2023;16:1220–9. DOI: 10.1016/j.jiph.2023.05.032.

MCPS F. Bacterial profile of burn wound infections in burn patients. Ann Pak Inst Med Sci. 2012;8(1):54–7.

Khattak AA, Awan UA, Haq M, Khalid S, Ashraf F, Nadeem MF. Microbiological profile and commonly used antibiotics susceptibility pattern of isolates among burn patients at a tertiary care hospital. J Med Sci. 2017;25(2):200–4.

Patil P, Kadganchi C, Srikanth Doddamani PK. Aerobic bacteriological profile and their antibiotic sensitivity pattern of burn wounds from burns patients at a tertiary care hospital in North Karnataka. Med Sci J. 2022;62(07):3143-3149.

Haghighifar E, Kamali Dolatabadi R. Bacterial infections and antimicrobial resistance patterns of burn wound infections: A one year study from burn Hospital, Isfahan, Iran. J Adv Med Biomed Res. 2020;28(128):144–50.

Rashid A, Saqib M, Deeba F, Khan JA. Microbial profile of burn wound infections and their antibiotic sensitivity patterns at burn unit of allied hospital Faisalabad. Pak J Pharm Sci. 2019;36(1SI):247–55.

Sarwar N, Ahmad B, Azam S, Rehman N. Identification and antimicrobial susceptibility profile of bacterial pathogens isolated from wound infections in a teaching hospital, Peshawar, Pakistan. Adv Life Sci. 2017;5(1):08–12.

Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clin Microbiol Rev. 2006;19(2):403–34. DOI: 10.1128/cmr.19.2.403-434.2006.

Pruitt BA, McManus AT. The changing epidemiology of infection in burn patients. World J Surg. 1992;16:57–67. DOI: 10.1007/BF02067116.

Basit M, Siddique AB, Aslam B, Zahoor MA, Hussain R, Ulhaq M. Distribution and antimicrobial susceptibility profile of bacterial and fungal pathogens isolated from burn wounds in hospitalized patients. J Pak Med Assoc. 2021;71(3):916–20. DOI: 10.47391/jpma.1245.

Saaiq M, Ahmad S, Zaib MS. Burn wound infections and antibiotic susceptibility patterns at Pakistan Institute of Medical Sciences, Islamabad, Pakistan. World J Plast Surg. 2015;4(1):9.

White EK, Grice EA. The wound microbiome. Cold Spring Harb Perspect Biol. 2023;15(6):a041218. DOI: 10.1101/cshperspect.a041218.

Pujji OJS, Nakarmi KK, Shrestha B, Rai SM, Jeffery SLA. The bacteriological profile of burn wound infections at a tertiary burns center in Nepal. J Burn Care Res. 2019;40(6):838–45. DOI: 10.1093/jbcr/irz096.

Gupta M, Naik AK, Singh SK. Bacteriological profile and antimicrobial resistance patterns of burn wound infections in a tertiary care hospital. Heliyon. 2019;5(12):e03074. DOI: 10.1016/j.heliyon.2019.e03074.

Rehan M, Iqbal T, Ghaffar N, Komal N, Khan MS. Bacteriological profiling of burn wound infections at the national burn care centre of Pakistan. BMC J Med Sci. 2023;4(1):43–8.

Emami A, Pirbonyeh N, Keshavarzi A, Javanmardi F, Moradi Ghermezi S, Ghadimi T. Three year study of infection profile and antimicrobial resistance pattern from burn patients in southwest Iran. Infect Drug Resist. 2020;1499–506. DOI: 10.2147/IDR.S249160.

Farva K, Bhutta GA. Prevalence of gram negative bacteria in infected burn wounds and antibiotic susceptibility pattern; A study of stable burn patients. Prof Med J. 2021;28(10). DOI: 10.29309/TPMJ/2021.28.10.6287.

Raza AA, Ibrahim M, Ishfaq R, Saleem I, Altaf MA, Asmat U. Incidence, Clinical Evaluation and Antibiogram of Bacterial Isolates Obtained from Burn Patients. Pak J Med Health Sci. 2022;16(10):282–282. DOI: 10.53350/pjmhs221610282.

Al-Habsi THA, AL-Lamki RNA, Mabruk M. Antibiotic susceptibility pattern of bacterial isolates from wound infections among patients attending a tertiary care hospital in Oman. Biomed Pharmacol J. 2020;13(4):2069–80. DOI: 10.13005/bpj/2087.

Sharma J, Sharma D, Singh A, Sunita K. Colistin Resistance and Management of Drug Resistant Infections. Can J Infect Dis Med Microbiol. 2022;33(1):45-52. DOI: 10.1155/2022/4315030.