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Microbiological Profile of Infections in a Tertiary Care Burns Unit
Ebenezer R1, Isabella Princess2, Rohit Vadala1
1Department of Critical Care Medicine, Apollo Specialty Hospitals, Vanagaram, Chennai, Tamil Nadu, India.
Background:
The burden of infections among burns patients is higher in healthcare settings due to partial or complete loss of skin as a physical barrier among these patients. We intend to present microbiological profile of patients admitted to a tertiary care hospital in South India.
Aim:
To describe microbiological profile of infections and antimicrobial susceptibility pattern of clinical isolates from burns patients in our tertiary care hospital.
Materials And Methods:
This retrospective analysis was done on consecutive patients admitted with burns over a period of three years at Apollo Specialty Hospitals, a tertiary care facility in Vanagaram, Chennai. Data analysis included clinical isolates from blood, urine, tissue, pus and tracheal aspirate. Types of bloodstream infections, urosepsis and antibiogram are described.
Results:
Among 219 clinical isolates from various samples, 75% were gram-negative, 19% gram-positive and 6% were yeast like fungi. Among bloodstream infections, 32% were polymicrobial. Urosepsis was observed in 39% patients. Wound infections with sepsis was seen in 39% patients. Gram-negative isolates showed better susceptibility to amikacin, carbapenems, beta lactam - beta lactamase inhibitor combinations. Gram-positive isolates had better susceptibility to macrolides, doxycycline, glycopeptides.
Conclusion:
The high prevalence of gram-negative, polymicrobial infections and multidrug resistant bacteria noted in our patients and the sensitivity patterns would help with appropriate decision on initial antibiotic therapy. However escalation and de-escalation of antibiotics should be planned based on culture reports.
How To Cite This Article:
Ebenezer R, Princess I, Vadala R, Kumar S, Ramakrishnan N, Krishnan G. Microbiological Profile of Infections in a Tertiary Care Burns Unit. Indian J Crit Care Med 2019;23(9):405-410.
Insights
Infections in burns patients are often caused by gram-negative bacteria, with polymicrobial infections being common. Understanding antimicrobial susceptibility patterns is crucial for effective treatment of burns unit infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Burn Care
Background:
- Burns patients face a high risk of healthcare-associated infections due to compromised skin barrier.
- Tertiary care settings present unique challenges for infection control in burn units.
Purpose of the Study:
- To determine the microbiological profile of infections in burns patients.
- To analyze the antimicrobial susceptibility patterns of clinical isolates from burns patients.
Main Methods:
- Retrospective analysis of patients admitted to a tertiary care hospital over three years.
- Inclusion of clinical isolates from blood, urine, tissue, pus, and tracheal aspirates.
- Description of bloodstream infections, urosepsis, and antibiograms.
Main Results:
- Gram-negative bacteria constituted 75% of isolates, followed by gram-positive bacteria (19%) and fungi (6%).
- Polymicrobial bloodstream infections occurred in 32% of cases; urosepsis and wound infections with sepsis were observed in 39% each.
- Gram-negative isolates showed susceptibility to amikacin, carbapenems, and beta-lactam/beta-lactamase inhibitor combinations; gram-positive isolates were susceptible to macrolides, doxycycline, and glycopeptides.
Conclusions:
- High prevalence of gram-negative, polymicrobial, and multidrug-resistant infections in burns patients.
- Identified sensitivity patterns aid in initial antibiotic therapy decisions.
- Emphasizes the need for culture-guided antibiotic escalation and de-escalation.
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