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ORIGINAL CONTRIBUTION |
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| Year : 1999 | Volume
: 53
| Issue : 5 | Page : 216-219 |
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Bacteriological analysis of burn sepsis
BS Nagoba1, SR Deshmukh1, BJ Wadher2, AB Pathan1
1 Department of Microbiology, M.I.M.S.R. Medical college, Latur., India
2 Department of Microbiology, Nagpur University, Nagpur., India
Correspondence Address:
B S Nagoba
Department of Microbiology, M.I.M.S.R. Medical College, Latur 413 531.
India
PMID: 10695232
How to cite this article:
Nagoba B S, Deshmukh S R, Wadher B J, Pathan A B. Bacteriological analysis of burn sepsis. Indian J Med Sci 1999;53:216-9 |
Infection of burn continues to be an ever-increasing problem. Burn injuries provide an excellent opportunity for vairous microorganisms to produce infection. Microbial contamination of burn is a life threatening complication. The detailed knowledge regarding the infecting organism and its antibiotic susceptibility pattern helps in selection of proper therapeutic regimen and thereby avoids further morbidity and mortality. In the present study an attempt has been made to investigate the pattern of bacterial infection in the burn wounds and their antibiotic susceptibilty pattern.
| ¤ Materials and Methods | |  |
A total of 65 swabs obtained from (09 males and 56 females) cases of deep and major burn injuries were processed for isolation and identification of bacteria to find out the cause of infection. Each swab was inoculated on blood agar, Mac-Conkey's agar and pseudomonas isolation agar. After overnight incubation at 37°C, growth on each plate was studied and identified using standard techniques. [1] Antibiotic susceptibility of each isolate was determined by Kirby-Bauer disk diffusion method. [2] Antibiotics ,used were ampicillin (10 mcg), co-trimoxazole (25 mcg), gentamicin (10 mcg), tetracycline (30 mcg), amoxycillin (30 mcg), norfloxacin (10 mcg) and ciprofloxacin (5 mcg). Carbenicillin (100 mcg) for gram negative bacilli and erythromycin (15 mcg) for gram positive cocci were used in addition.
| ¤ Results and Discussion | | |
A prevalence infection rate of 100% was observed in the present study. The high infection rate in burn cases has also been reported by earlier worker. [3],[4],[5],[6]
In the present study P. aeruginosa (53.8%) was found to be the most common cause of burn infection followed by S aureus (38.4%), Klebsiella Spp. (27.6%), Proteus Spp (18.4%), E coli (10.7%), S Albus (9.2%), S pyogenes (7.6%), Citrobacter Spp (6.1%), Serattia Spp (1.5%) and S. circus (1.5%) others with predominance of gram negative bacilli. Similar findings have been reported by others [3],[6] . The predominance of gram negative bacilli and P. aeruginosa as the most common agent has also been reported by other workers. [4],[7],[8]
Of the 65 burn infection cases studied, the isolation was mono-bacterial ;in 25 cases (38.4%) ; organisations were P aeruginosa (15.3%), S aureus (12.3%), S pyrogenes (3.0%), Salbus (3.0%), Klebsiella (1.5%), serrati Spp (1.5%) and cirobecter spp (1.5%). In 40 cases (61.5%) the isolation was polybacterial and P. aeruginosa„ S. aureus, Klebsiella Spp., Proteus Spp. and E. coll were the predominant bacteria seen in different combinations [Table 1] The polybacterial isolation rate in the present study is higher as compared to 18% of Nagesha et al. [6] This may be attributed to the selection of cases with deep and major burns in the present study. However, the predominance of P.aeruginosa in both monobacterial and polybacterial infections is similar to Nagesha et al. [6]
Majority of the isolates were found resistant to most of the antibiotics. Ciprofloxacin (42.9%) was found to be the most effective agent in the present study. Erytrhomycin (27%) was found effective against gram positive cocci. All other agents including norfloxacin and gentamicin were found effective against less than 20% isolates [Table 2]. Resistance to antibiotics in burn isolates has been reported previously. [3],[4],[7] Han reported gradual decrease in sensitivity year by year. [4] In a study of Bairy et al. [3] Ciprofloxacin and gentamicin were the only effective antimicrobial agents. [3] Zhang found that ciprofloxacin was comparatively more active [9] but in the present study ciprofloxacin has also shown limited activity. This indicates that resistance to antibiotics including ciprofloxacin in increasing day by day.
From the present study it is concluded that 1. P. aeruginosa, S. aureus and other gram negative bacteria play an important role in burn sepsis. 2. Because of high degree of resistance in burn isofates, the knowledge of susceptibility pattern of infecting agent would help the clinician in selection of proper antibiotic.
| ¤ Summary | | |
A total of 114 opportunistic bacteria were isolated from 65 swabs from burn sepsis. P. aerugirrosa (53.8%) was the most common agent followed by S. aureus (38.4%), Kliebsiella Spp. (27.6%), Proteus (18.4%), E.colt (10.7%) and others. The infection was monobacterial in 25 cases (38.4%) and polybacterial in 49 cases (61.5%). P. aeruginosa was predominated in both monobacterial and polybacteiral infections. Ciprofloxacin (42.9%) was found to be the most egective antibacterial agent. Results indicate that resistance in burn isolates is higher and increasing day by day.
| ¤ References | | |
| 1. | Collee JS, Duguid JP, Fraser AG, Marmion BP. Mackie and Mc Cartney Practical Medical Microbiology 13th ed Churchill-Livingstone Edinburgh 1989:141.  |
| 2. | Bauer AW, Kirby WMM, Sherris JC, Truck M. Antibiotic susceptibility testing by a standardized single disk method. Am J clin pathol 1966;45:493-496. |
| 3. | Bairy I, Shivananda PG. Aerobic bacterial flora of burn wound infection. Indian J Surg 1997;59:215-218. |
| 4. | Han ZX. A variety of microorganism species at the burn ward. Chung Hua wai ko Tsa chin 1989; 27:546-549. |
| 5. | Winkler M, Erbs G, Muller FE, Konig W. Epidemiological studies of the microbiol Colonization of severely burned patients. Zentralbl Bakteriol-Microbiol-Hyg-B 1987:184:304-320. |
| 6. | Nagesha CN, Shenoy KJ, Chandrahekasr MR. Study of burn sepsis with special reference to Pseudomonas aeruginosa. J Indian Med Asso 1996;94:230-233. |
| 7. | Zhang YP, Opportunistic infection and systemic dissemination in burns. Chung Hua wai Tsa chin 1989:2x:750-752 and 781-782. |
| 8. | Hooda RS, Chhabra HL, Chugh TD, Keswani RK. Bacteriology of burn wound sepsis in a general surgical ward. Burns 1997;3:181-188. |
| 9. | Zhang YP. Common pathogens in burn infection and changes in their drug sensitivity. Chung Hua cheng Hising shao shang wai ko Tsa chin 1991:7:108-110. |
[Table 1], [Table 2]
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