Bacterial infections in burn wound patients at a tertiary teaching hospital in Accra, Ghana

Intact human skin surface is essential for protection against infection, preservation of body fluid homeostasis and thermoregulation. Burn injury compromises the skin barrier and enables bacterial infection, hence delaying burn wound healing. This study aimed to determine the microbial profile of burn wounds, and resistance patterns of microbes with respect to the source of the injured patient's wound. Fifty wound swab samples were collected from fifty burn patients at the Korle-Bu Teaching Hospital, Accra (KBTH). Sterile swabs moistened with sterile saline were used to swab burn wounds. The swabs were plated on blood agar and MacConkey agar for 24 hrs at 37°C. Biochemical tests were carried out on the representative isolate on each plate, and antibacterial sensitivity pattern was determined using the Kirby-Bauer disc diffusion method. The study revealed that the main source of burns was gas flames (66%) and scalds (28%). Out of the 50 samples analysed, 86% were culture positive and 14% were culture negative for bacteria. The predominant organisms isolated were Pseudomonas sp. (30.2%) and Acinetobacter sp. (20.9%). Proteus mirabillis (2.3%) and Staphylococcus aureus (2.3%) were the least frequently isolated bacteria. Although Pseudomonas sp. showed varying resistance levels to gentamicin, cotrimoxazole and ciprofloxacin, all the Acinetobacter sp. were resistant to most of the tested antibiotics used. Resistant gram negative bacteria are the most common isolates associated with burn wounds in Accra, Ghana. Hence a careful selection of antibiotics to control the wound infection is required for proper management of burn wounds in order to help reduce morbidity and mortality.