Bacteriologic Profile of Burn Wounds at a Tertiary Government Hospital in the Philippines—UP-PGH ATR Burn Center

Abstract

Wound infection is a major cause of morbidity and mortality among burn patients. Recent changes in the epidemiology of burn wound infections were observed due to the steady rise of drug-resistant bacteria. The objective of this study is to determine the most common burn wound pathogens isolated among patients admitted at the UP-PGH ATR Burn Center, describe their respective susceptibility patterns, and calculate incidence rates of burn wound colonization, local, and invasive infection. Patients admitted at the UP-PGH Burn Center from March 2015 to February 2016 with tissue culture studies were monitored for development of wound infection; patient charts, tissue isolates, and their susceptibility patterns were reviewed. A total of 77 patients were included in the study wherein 36% had no infection, 42% had wound colonization, and 22% developed burn wound infection. Among these patients, 98 specimens were sent for culture studies which revealed Acinetobacter baumannii (25.6%) as the top pathogen isolated, followed by Enterococcus sp. (21.95%), and Pseudomonas sp. (18.29%). Acinetobacter baumannii was also the top isolate among patients with local and invasive infection (86 and 67%, respectively). Multidrug resistance was observed with A. baumannii and Pseudomonas exhibiting resistance towards meropenem, imipenem, cefepime, ciprofloxacin, and piperacillin-tazobactam but remained sensitive to colistin, amikacin, and minocycline. Vancomycin, cotrimoxazole, and ciprofloxacin were active against Gram-positive bacteria. Multidrug-resistant organisms pose a major risk in all burn units. To limit their growth, judicious use of antibiotics, aggressive infection control measures, close surveillance, and frequent antibiograms are needed.

Epidemiology and Early Bacteriology of Extremely Severe Burns from an LPG Tanker Explosion in Eastern China

“…Additionally, there was an obvious increase in the carbapenem-resistant and methicillin-resistant organisms, consistent with other studies [ 13 , 16 , 17 ]. Notably, a 10-year retrospective study in Turkey showed a decrease in carbapenem resistance form Pseudomonas aeruginosa although that in Acinetobacter baumannii increased to 94%, over time [ 18 ].…”

“…Previous reports showed that the burn wound was typically colonized with Gram-positive bacteria within 2 days while Gram-negative bacteria colonized the wound after 2–3 days [ 7 , 12 ], similar to observations from the present study. Additionally, the most isolated organisms were Gram-negative bacteria, corroborating with previous studies [ 11 , 13 ]. However, Stenotrophomonas maltophilia was shown to be one of the most common Gram-negative organisms, contrary to previous findings [ 7 , 14 ] which reported that Acinetobacter baumannii was the predominant Gram-negative bacteria.…”

“…Nonetheless, a 5-year survey on severe burns in South Korea similarly reported that the Enterococcus species replaced Staphylococcus aureus as the most common Gram-positive bacteria [15]. Additionally, there was an obvious increase in the carbapenem-resistant and methicillin-resistant organisms, consistent with other studies [13,16,17]. Notably, a 10-year retrospective study in Turkey showed a decrease in carbapenem resistance form Pseudomonas aeruginosa although that in Acinetobacter baumannii increased to 94%, over time [18].…”

Application of Phagotherapy in the Treatment of Burn Patients (Review)

“…Burn wounds are especially sensitive to infection for several reasons. Destruction of the epidermal barrier in combination with denaturation of proteins and lipids creates a favorable medium for microbial growth [ 36 , 37 ]. Since it is impossible to make the required concentration of the systemically introduced antibiotics into the damaged tissues with impaired blood circulation, local application of antimicrobial preparations becomes ever more vital [ 38 , 39 ].…”

Infektionspräventive Maßnahmen in der Verbrennungschirurgie

“…ten in einer Analyse auf einer niederländischen Brandverletzten-Intensivstation über 7 Jahre hinweg(2005- 2011) bei Wundabstrichen Staphylococcus aureus als häufigsten Erreger und die Zunahme resistenter gramnegativer Bakterien (nicht signifikant)[12]. Abesamis et al untersuchten in einer Studie das bakte-riologische Profil von Verbrennungswunden in einem Brandverletztenzentrum der Philippinen[13].ESKAPEDie häufigsten Erreger auf Verbrennungswunden gehören somit zu den ESKAPE-Pathogenen (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa und Enterobacter-Spezies). Aufgrund ihrer Fähigkeiten, besonders ausgeprägte Antibiotikaresistenzen auszubilden, werden die therapeutischen Möglichkeiten knapp.…”