Emerging Changes in Mortality Pattern of Burn Patients in Relation to Resistant Bacterial Isolates in a Tertiary Care Hospital

Abstract

Burn injury is a global public health problem with approximately 265,000 deaths annually. In India, over 1000,000 people are moderately or severely burnt every year and an annual mortality rate is 100,000 to 140,000. This study was aimed to identify and analyze the demographic aspects, various micro-organisms responsible for burn wound infections and antimicrobial resistance as predictors of mortality in burn patients so that preventive measures can be recommended and implemented to reduce mortality among burn patients. Wound swabs from 75 patients admitted in Burn unit with TBSA (total burn surface area) between 10% - 60% and having age between 10- 60 years were included in the study. In our study, case fatality rate was 26.7% with maximum mortality between 19-26 yrs of age and among females (36.6%). As the percentage of burns increase, the mortality rate also increases. The most common organism isolated was Pseudomonas aeruginosa (45%), followed by Klebsiella pneumoniae (28.2%) and Acinetobacter baumanii (19.7%) and all the bacterial isolates in expired patients were MDR (multidrug resistant). MBL (metallo-beta-lactamase) producing isolates were more common among non-survivors than among survivors. This suggests that all the isolates should be screened for drug resistance parameters to reduce mortality and antibiotic policy should be framed for burn unit to prevent the spread of MDR organisms in admitted patients. Further strict infection control strategies should be implemented to achieve the ultimate objective of improving infection related morbidity and mortality in burn patients.