Microbiological Profile and Antimicrobial Resistance in Burn Unit of Ramathibodi Hospital

Abstract

Background: Infection of burn patients remains a major challenge due to an immunocompromised state and prolonged hospitalization. Knowing bacteriology and antibiotic susceptibility would therefore facilitate tailored management of infection in the Burn Unit. Objective: To investigate microbiological profile and antimicrobial resistance in the Burn Unit, Ramathibodi Hospital. Materials and Methods: A retrospective review of patients admitted to the Burn Unit was conducted during a two-year period (June 2019 to May 2021). Demographic data of infected and non-infected patients were collected including percentage of total body surface area (%TBSA), number of operations, length of hospital stay, and mortality. Bacterial isolates were cultured from burn wounds and blood. Antibiotic resistant profile of all common pathogens was analyzed. Results: A total of 49 burn patients were included. There were 33 patients (67.3%) in the infected group and 16 patients (32.7%) in the non-infected group. Infected patients had larger burn sizes (25.5 vs. 4.0 %TBSA, p=0.001) and required more operations (4 vs. 0.5, p=0.008) and longer hospitalization (36 vs. 11.5 days, p<0.001). Nevertheless, mortality of both groups was not significantly different (9.1% vs. 0%, p=0.213). Of all 212 bacterial isolates, the common organisms from the wounds were Pseudomonas aeruginosa (25.0%), Klebsiella pneumoniae (20.8%), and Enterococcus faecalis (16.5%). The common pathogens from 16 isolates of hemocultures were coagulase-negative staphylococcus (12.5%), Klebsiella pneumoniae (12.5%), and Proteus mirabilis (12.5%). Acinetobacter baumannii and Pseudomonas aeruginosa were two majority of multiple-drug resistant organisms (MDROs). These two strains were resistant to most antibiotics. However, colistin was still effective against the MDROs. Conclusion: The present study reviewed the prevalence of bacterial infection obtained from burn wounds and hemocultures to determine the bacteriological profile and antibiotic resistant patterns. This knowledge help improve decision making for appropriate antibiotic prescription in the Burn Unit.