Microbiological profile of skin graft infections with special reference to Biofilm formation

Background: Infection of the skin graft is the common complication leading to failure of the graft. Successful skin graft “TAKE” is less likely to occur on experimental or clinical wounds that contain more than 105 viable bacteria per gram of tissue. Skin graft infection with organisms forming biofilm puts a great financial burden on patients and could lead to morbidity and mortality. Appropriate pre and post operative wound care, adequate antibiotic therapy and surgical strategies must be described to eradicate infection. For the above reason this study was done. Methods: It is a prospective cross sectional study where 100 patients having skin graft infection were included in the study from Feb 2014 – July 2015; The study was conducted in the department of Microbiology B&LCH, samples were taken from patients attending plastic surgery department. Results: Skin grafting done for burn wounds was the one most commonly affected both in males and females .Pseudomonas aueriginosa was the organism most commonly isolated and also the organism causing biofilm followed by Methicillin resistant staphylococcus aureus and Klebsiella spp. No anaerobes and fungal species were isolated. Unhygienic practices and Diabetes Mellitus were found to be important risk factors. Biofilm forming organisms were commonly associated with antibiotic resistance, so even aggressive antibiotic therapy was also inadequate to eliminate infection. Conservative surgical treatment (debridement) was necessary. Conclusion: The gram negative bacteria are more predominant as causative agents of skin graft infections than the gram positive bacteria. The commonest organism causing skin graft infection and forming biofilm is pseudomonas species. Appropriate pre and post operative wound care ,adequate antibiotic therapy, and surgical strategies must be described to eradicate infection.