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Study of burn sepsis with special reference to Pseudomonas aeruginosa
C N Nagesha1, K J Shenoy, M R Chandrashekar
1Department of Microbiology, Dr BR Ambedkar Medical College, Bangalore.
Abstract:
Fifty cases of burn of different degrees were subjected to clinical and microbiological studies. A total of 60 isolates were obtained. Of these, 40 (80.0% incidences) were Ps aeruginosa, 8 (16.0 incidences) Staph pyogenes, 6 (12.0% incidences) Kl pneumoniae, 4 (80.0% incidences) Esch coli and 2 (4.0% incidences) C albicans. Monobacterial cultures showed isolations in 41 cases (82.0%) and 34 (68.0%) of them were Ps aeruginosa. At the time to admission 42 cases (84.0%) were infected and during one week of hospitalisation another 8 cases (16.0%) were infected yielding an overall infection rate of 100%. The commonest organism on admission and after hospitalisation was Ps aeruginosa with isolation rates of 60.0% (30) and 20.0% (10) respectively. Gram-negative bacilli, predominantly Ps aeruginosa were found in the lower part of the body with an incidence of 74.0% (37). Staph pyogenes was found in the upper half showing an incidence of 12.0% (6) next to 20.0% (10) incidence of Ps aeruginosa. The incidence of burn infection was high in patients with deep and major burn wounds, the bacterial isolates being 76.0% (38) and 80.0% (40) respectively. Silver sulphadiazine exhibited antimicrobial action in the range of 14 to 390 microM/ml, while cerium sulphadiazine had no inhibitory effect even up to 667 microM/ml on pseudomonas isolates. Zinc sulphadiazine was effective in inhibiting the growth of 10 isolates tested in 40 to 297 microM/ml range.
Insights
Pseudomonas aeruginosa was the most common burn wound infection, particularly in deep and major burns. Silver sulphadiazine showed antimicrobial action, unlike cerium sulphadiazine.
Area of Science:
- Infectious Diseases
- Microbiology
- Burn Care
Background:
- Burn wounds are susceptible to microbial colonization and infection.
- Pseudomonas aeruginosa (Ps aeruginosa) is a common pathogen in burn infections.
- Identifying prevalent microorganisms is crucial for effective treatment strategies.
Purpose of the Study:
- To investigate the microbiological profile of burn wound infections.
- To determine the incidence and common sites of infection.
- To evaluate the efficacy of different silver-based antimicrobial agents.
Main Methods:
- Clinical and microbiological analysis of 50 burn cases.
- Isolation and identification of bacterial and fungal pathogens.
- Assessment of antimicrobial activity of silver sulphadiazine, cerium sulphadiazine, and zinc sulphadiazine.
Main Results:
- Pseudomonas aeruginosa was the most frequent isolate (80.0%), followed by Staphylococcus pyogenes (16.0%).
- Infection rates reached 100%, with Ps aeruginosa being dominant on admission and after hospitalization.
- Deep and major burns showed higher infection incidence; Ps aeruginosa was prevalent in lower body burns, and Staph pyogenes in upper body burns.
- Silver sulphadiazine demonstrated antimicrobial activity against Ps aeruginosa, while cerium sulphadiazine was ineffective. Zinc sulphadiazine showed moderate efficacy.
Conclusions:
- Pseudomonas aeruginosa is a primary pathogen in burn wound infections, especially in severe burns.
- Topical silver sulphadiazine remains a viable treatment option, whereas cerium sulphadiazine lacks efficacy.
- Comprehensive microbiological surveillance and targeted antimicrobial therapy are essential for managing burn infections.