Bacteriological profile of burn wound infection following blast injury in a tertiary care centre

Burn trauma is as old as the discovery of fire in the history of mankind.. Injuries secondary to severe burns rank among the most serious forms of trauma resulting in anatomic, physiologic, endocrinology and immunologic stresses especially when burns involve >20% of total body surface area. Significant thermal injuries induce a state of immuno suppression that predisposes burn patients to infectious complications. The organisms responsible for infections in patients who suffer severe burns may be endogeneous or exogeneous which include bacteria, fungi and viruses which can change over time in the individual patient. A total no. of 22 patients with age group ranging from 16 years to 70 years with 10% to 70% burns were brought to the casualty of the Govt. Medical College, Trivandrum, following an accidental blast injury which occurred in a temple premises at Puttingal, a village at Kollam District in Kerala on 10/04/2016. A total no of 56 samples ofexudates, 10samples of blood for culture and sensitivity were received within 24 hours central microbiology Laboratory at Govt. Medical College Hospital Trivandrum from the third day of admission onwards. The most common bacteria isolated from the exudates was Pseudomonas aeruginosa (39.58%) followed by Acinetobacter species (27.08%) Klebsiella pneumoniae (20.83%) MRSA (8.33%) and Staphylococcus aureus (2.08%) and Enterococcus faecalis (2.08%). Blood culture was positive in 30% samples. Multi Drug Resistant strains of pseudomonas aeruginosa, Ecoli and Acinobacterbaumanii were isolated from blood samples. Centralline tip from one patient and tracheal aspirate from two patientsyielded Acinobacterbaumanii. The patients were treated with appropriate antibiotics according to the antibiotic sensitivity pattern of the isolates obtained from clinical specimens and surgical interventions done wherever needed. The mortality rate was 9.07% in this study. This is significantly less when compared to many other studies, the reasons being strict and efficient Infection Control Practices in our institution.