BACTERIOLOGICAL TRENDS AND CULTURE – SENSITIVITY PATTERNS OF BURN WOUNDS AT BURN UNIT, MAYO HOSPITAL, LAHORE

Abstract

Abstract

Objectives:  To determine the pattern of bacterial gro-wth over time and to devise an antibiogram based on sensitivities to antibiotics in burn wounds of patients amitted in burn unit admitted to burn unit, Mayo hos-pital, Lahore.

Jan S.N.¹

Senior Registrar

Plastic and Reconstructive Surgery, Mayo Hospital, Lahore

Ansari H.H.²

Chairman, Department of Plastic Surgery and Reconstructive Surgery, KEMU / Mayo Hospital, Lahore

Mir Z.A.³

Medical Officer, Plastic and Reconstructive Surgery

Mayo Hospital, Lahore

Khan B.A.⁴

Post Graduate Resident

Plastic and Reconstructive Surgery, Mayo Hospital, Lahore

Shami H.B.⁵

Post Graduate Resident

Plastic and Reconstructive Surgery, Mayo Hospital, Lahore

Nasir M.⁶

Post Graduate Resident

Plastic and Reconstructive Surgery, Mayo Hospital, Lahore

Design:  Descriptive case series.

Place and Duration of Study:  Burn unit of Mayo Hospital Lahore from august 2013 to august 2014.

Patients and Methods:  All consecutive burn patients admitted within 72 hours of their injury from August 2013 to August 2014 were included. Patients who died before the 2^nd culture were excluded from the study. 181 culture reports of 79 burn patients with burn areas between 5 and 70 % were studied. Cultures were sent on the third day of burn and then weekly. The reports were scrutinized for organism type and antibiotic sen-sitivity. The shift in organism pattern on subsequent cultures was noted.

Results:  Of the 79 patients 44 were females and 35 were males. 61 were flame burns, 7 were acid burns while 11 were high voltage electric contact and flash burns. Mean age of patients was 33.22 ± 12.74 years and mean percentage of burn surface area was 33.18 ± 13.33%. All patients had mixed thickness burns mostly deep partial thickness variety. Staphylococcus aureus was the most common pathogen isolated on initial cultures (68.18%). Pseudomonas aeruginosa (28.46%) and enterobacteraciae (26.15%) were the most com-mon isolates on subsequent cultures. Tazobactam / Piperacillin (35.32% of organisms) followed by Cefpe-razone / Sulbactam (19.27% of organisms) and Ami-kacin (16.97% of organisms) were the most sensitive antibiotics on culture and sensitivity.

Conclusion:  Our study shows that the microbial pro-
file of a burn wound shifts from an initial predomi-nantly gram positive isolate to a later predominantly gram negative isolate. Also Tazobactam/Piperacillin was found to be the most sensitive antibiotic on culture and sensitivity in our study.

Keywords:  Burn wounds, Burn microorganisms, Burn antibiotics, burn antibiogram.