Rashid Abid, Saqib Muhammad, Deeba Farrah, Khan Junaid Ali
Department of Clinical Medicine and Surgery, Faculty of Veterinary Science, University of Agriculture, Faisalabad, Pakistan / Directorate of Medical Sciences, Government College University, Faisalabad, Pakistan.
Department of Clinical Medicine and Surgery, Faculty of Veterinary Science, University of Agriculture, Faisalabad, Pakistan.
Pak J Pharm Sci. 2019 Jan;32(1(Supplementary)):247-254.
Microbial infection is the most common and serious complication of burn injury, which is a major cause of morbidity and mortality. The aim of this study was to determine the bacteriological profiles and the antibiotic sensitivity patterns in burn unit of Allied Hospital Faisalabad over a period of 1 year. During the study period, 393 samples were collected and cultured by conventional method. Disk diffusion method was used to determine the sensitivity/resistance pattern of the isolates. Results were analyzed using SPPS version 20. Out of 393, 332 (84.5%) cases were found to be culture positive. Microbial contamination of the burn wounds was significantly (p<0.05) higher in males (89.3%) as compared to females (78.1%), and in 3rd degree burns (92.2%) as compared to 2nd degree burns (80.8%). Out of 393 patients, 258 (65.6%) cases were of Staphylococcus aurous followed by 169 (43.0%) of Pseudomonas aeruginosa 79 (20.1%) of Klebsiella pneumoniae and 67 (17.0%) of Escherichia coli. Among 258 cases of S. aurous, 153 (59.3%) were MRSA and 105 (40.7%) were MSSA. A large proportion (92.8%) of MRSA was sensitive to techoplanin and exhibited high-level resistant (96.7%) to fusidic acid whereas, significant proportion (74.4%) of MSSA isolates showed resistant to fusidic acid. A zero resistance was noted in coagulase negative staphylococci to linezolide, vancomycin and teichoplanin.. Pseudomonas aeruginosa exhibited high level resistance to tobramycin (91.7%) and were mostly sensitive (93.5%) to cefipiem. Klebsiella penumoniae was most sensitive to meropenem (100%) and most resistant to tobramycin (63.3%). E. coli showed zero resistance cefipiem and a small proportion of isolates (14.9%) exhibited resistance to tobramycin. In conclusion, S. aurous and P. aeruginosa represented the most common bacterial microbes of burn wounds which exhibited variable antibiotic susceptibility pattern. This study revealed a high potential for multiple microorganism outbreaks and emergence of resistant pathogens in burn patients due to the lack of patient screening and extended empirical use of antibiotics.
微生物感染是烧伤最常见且最严重的并发症，是发病和死亡的主要原因。本研究的目的是确定费萨拉巴德联合医院烧伤科1年内的细菌学特征和抗生素敏感性模式。在研究期间，收集了393份样本并采用常规方法进行培养。采用纸片扩散法确定分离株的敏感/耐药模式。使用SPPS 20版对结果进行分析。在393例样本中，332例（84.5%）培养呈阳性。男性烧伤创面的微生物污染率（89.3%）显著高于女性（78.1%）（p<0.05），三度烧伤的微生物污染率（92.2%）高于二度烧伤（80.8%）。在393例患者中，258例（65.6%）为金黄色葡萄球菌感染，其次是169例（43.0%）铜绿假单胞菌感染、79例（20.1%）肺炎克雷伯菌感染和67例（17.0%）大肠杆菌感染。在258例金黄色葡萄球菌感染病例中，153例（59.3%）为耐甲氧西林金黄色葡萄球菌（MRSA），105例（40.7%）为甲氧西林敏感金黄色葡萄球菌（MSSA）。大部分（92.8%）MRSA对替考拉宁敏感，对夫西地酸表现出高水平耐药（96.7%）；而相当比例（74.4%）的MSSA分离株对夫西地酸耐药。凝固酶阴性葡萄球菌对利奈唑胺、万古霉素和替考拉宁的耐药率为零。铜绿假单胞菌对妥布霉素表现出高水平耐药（91.7%），对头孢吡肟大多敏感（93.5%）。肺炎克雷伯菌对美罗培南最敏感（100%），对妥布霉素耐药率最高（通 63.3%）。大肠杆菌对头孢吡肟的耐药率为零，一小部分分离株（14.9%）对妥布霉素耐药。总之，金黄色葡萄球菌和铜绿假单胞菌是烧伤创面最常见的细菌微生物，它们表现出不同的抗生素敏感性模式。本研究表明，由于缺乏患者筛查和抗生素的广泛经验性使用，烧伤患者中存在多种微生物爆发和耐药病原体出现的高风险。
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