Saturday, 14 November 2015

Bacteriological Profile of Burn Wound Infection in a Tertiary Care Hospital in North India with Special Reference to Methicillin Resistant Staphylococcus aureus

Abstract Methicillin-resistant Staphylococcus aureus (MRSA) poses a great risk to burn patients with potential to cause significant morbidity and mortality. This study aimed to find out the prevalence of MRSA and its susceptibility, in burn wound infection/colonization in a Tertiary Care Hospital in North India. A retrospective study was conducted among patients admitted in burn ward of our hospital, between January to December 2012. All the patients irrespective of age, sex, duration of hospital stay, percentage and degree of burn were included in our study. Wound swabs from 1294 patients hospitalized in burn ward were analysed for bacteriological examination. Swabs were inoculated on Blood agar, MacConkey agar and Brain heart infusion broth. Isolates were examined for colony characteristics, Gram staining and biochemical tests. Antimicrobial susceptibility testing was done by modified Stokes disc diffusion method. Detection of MRSA was done by cefoxitin (30mg) disc diffusion method. Among the Staphylococcus aureus (S.aureus) isolates, 56.7% (80/141) were found to be MRSA while 43.3% (61/141) were Methicillin Susceptible S.aureus (MSSA). All the MRSA isolates were resistant to penicillin, cephalexin and cefazolin. Resistance to erythromycin, clindamycin, ofloxacin, ciprofloxacin, gentamicin, amikacin, rifampicin, chloramphenicol was found to be 74%, 97.4%, 96%, 100%, 97.4%, 84.6%, 11.5%, 10.3%. All MRSA isolates were found to be sensitive to vancomycin and teicoplanin while 1.3% were resistant to linezolid. Although survival rates for burn patients have improved substantially over the years, nosocomial infections still remain a major challenge in burn care. This concludes that there is high prevalence of nosocomial infections specially the presence of multidrug resistant bacteria like Methicillin Resistant Staphylococcus aureus among burn patients suggest continuous surveillance of burn wound infections and development and stringent implementation of antibiotic policy.

Key-words: Methicillin Resistant Staphylococcus aureus (MRSA), Methicillin Susceptible Staphylococcus aureus (MSSA), Antimicrobial susceptibility testing, burn wound infection.

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