oa Southern African Journal of Epidemiology and Infection - Bacteriological profile and antibiogram of aerobic burn wound isolates in Mthatha, Eastern Cape, South Africa : original research
Burn wound colonisation and infection is not only associated with delayed wound healing and scar formation, but may also lead to sepsis-related mortality. A wide variety of microorganisms, like staphylococcus aureus, Pseudomonas aeruginosa, and Enterobacteriaceae-like Klebsiella pneumoniae and Escherichia coli, are involved. Resistance is generally increasing, with reports of multidrug- and pan-resistant isolates. This study was conducted to determine the common aerobic bacterial isolates in our setting and describe their antimicrobial susceptibility. This retrospective, descriptive study was carried out on 243 patients, from whom 312 burn wound specimens were received by the Nelson Mandela Academic Hospital microbiology laboratory of the National Health Laboratory Service, Mthatha. All samples were processed according to standard laboratory protocols; isolates were tabulated according to age and gender of the patients, and their percentage susceptibilities to relevant antibacterials were computed. A total of 229 patient specimens showed growth on culture. The total number of isolates was 629, out of which 269 were Gram-positive cocci and 360 were Gram-negative bacilli. The commonest organism was S. aureus (27.7%), followed by K. pneumoniae (13.4%), Proteus mirabilis (12.4%), Group D streptococcus (9.4%), P. aeruginosa (8.9%) and E. coli (6.2%). A generally high level of resistance was observed in many organisms. Methicillin-resistant S. aureus accounted for 57.5% of the S. aureus. Resistance among the Gram-negative bacilli was, in general, least to imipenem, amikacin and ciprofloxacin. The common organisms causing burn wound infections in our setting include staphylococci, Klebsiella, Proteus and Pseudomonas and there is a high level of resistance against commonly used antimicrobials. Regular surveillance of burn wound organisms and their antimicrobial resistance patterns will help in determining empirical antibiotic therapy for subsequent related septic events.
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