Antimicrobial resistance pattern of bacterial isolates from burn wounds in an Iranian University Hospital

About 73% of death cases in the first 5 days after burning are due to infection complications. The aim of this study was to identify the causing agents of infections in burn patients and the sensitivity pattern of them to the commonly used antimicrobials in an Iranian Burn center University Hospital.

In this cross-sectional study, patients who were admitted to one of the Iranian Burn center University hospitals in 2009 and had nosocomial infection due to burn wound, whom received antimicrobial agents for therapeutic reasons, with a hospitalization period of more than 48 hours were enrolled. Gram stain analyses were performed to help identifying growing colonies. Differential tests for identification of pathogenic bacteria species were performed following primary tests. E-test strips of each antimicrobial were placed on the culture medium plate in order to determine the minimum inhibitory concentration Studied antimicrobials for isolated Gram-negative bacteria were meropenem, piperacillin/tazobactam, ceftriaxone, cotrimoxazole, and for Staphylococcus aureus, vancomycin, piperacillin/tazobactam, cotrimoxazole, and cephalothin.

Only 16% of Pseudomonas aeruginosa species were sensitive to meropenem, and 13% were sensitive to piperacillin/tazobactam. Ten out of 29 Klebsiella species (34%) were sensitive to meropenem and piperacillin/tazobactam. All isolated strains of Staphylococcus aureus were sensitive to vancomycine while they were all resistant to cotrimoxazole.

Pseudomona, Klebsiella and Staphylococcoci are the most common species causing burn infection in this medical center. Results showed the importance of limiting irrational use of wide-spectrum antimicrobials and recommends strict management of infections in burn injury centers.