Infectious agents and antibiotic resistance in the burn unit

Aim: In terms of hospital infections, patients in the burn unit have a special importance. In these patients, the physical, cellular and humoral defense systems are impaired, and the potential of microorganisms to cause infection increases. In our study, it was aimed to determine the types of microorganisms isolated from all cultures taken from patients hospitalized in the burn unit of our hospital, the types of infections they cause, and antibiotic resistance and antibiotic resistance rates. Material and Methods: In our study, microorganisms and antibiotic resistance profiles isolated from patients hospitalized in the Burn Unit of Dr. Lutfi Kirdar Kartal Training and Research Hospital between January 1 and December 31, 2009 were evaluated retrospectively. Results: During this period, 458 patients hospitalized in the burn unit were followed up and 327 microorganisms were isolated from 116 (25.3%) patients. Of these microorganisms, 72.2% were Gram-negative bacteria, 20.2% were Gram-positive bacteria, and 7.6% were fungi. The most frequently isolated microorganisms were Pseudomonas aeruginosa (31.2%) and Acinetobacter baumannii (29.4%), followed by Staphylococcus aureus (9.2%) and Candida spp. (7.0%). The antibiotics to which Pseudomonas aeruginosa was most sensitive were amikacin, ciprofloxacin, gentamicin, meropenem and imipenem, respectively, while the most antibiotic resistance was found to cefoperazone-sulbactam and piperacillin-tazobactam. Acinetobacter baumannii was most sensitive are colistin and tigecycline; while no resistance to colistin was detected, resistance to tigecycline was found to be 14.3%. There was more than 90% resistance to other antibiotics. Methicillin resistance was found in 83.3% of the isolated Staphylococcus aureus strains, and no resistance was found to vancomycin, teicoplanin and linezolid in any of the Gram-positive bacteria. Discussion: Gram-negative bacteria, mainly Pseudomonas aeruginosa and Acinetobacter baumannii, constitute the dominant flora in the burn unit, and in these microorganisms, high resistance to antibiotics was noted. For the empirical antibiotic approach, each unit should follow its own infection surveillance and antibiotic resistance rates, and in order to prevent infections, infection control measures should be followed and the appearance of infection should be prevented.