Colonization of Burn Wounds and Susceptibility of Bacterial Isolates

The aim of the present study was to assess the time-related changes in the microflora of burn wounds in our setting and to determine the susceptibility pattern to commonly used antibiotics. In a period of 8 months a total of 90 burn wound samples (swabs) from 23 hospitalized patients at the Burn Unit were sent for microbiological examination. Swabs were taken weekly in a period of four weeks or until the patients were dismissed from the hospital. Isolation, identification of bacteria and determination of the antimicrobial susceptibility were according to standard microbiological techniques. In the first and second week of hospitalization, the predominant organism was Acinetobacter spp. By the end of the third week, Pseudomonas aeruginosa had become more predominant. In a period of four and more weeks of hospitalization, 7 samples from two patients were positive (yielding double and triple isolates) with further prevalence of Acinetobacter spp. Most of Gram-negative isolates were multidrug-resistant. Acinetobacter spp isolates were resistant as follows: 100% to amoxicillin-clavulanic acid and to cephalosporins, 86.4% to cefepime, 91% to both amynoglycosides, 88.6% to ciprofloxacin and co-trimoxazole, and 84% to piperacillin/ tazobactam and carbapenems. P. aeruginosa isolates were resistant as follows: 100% were resistant to AMC, cefuroxime and cefixime, 95% to co-trimoxazole, from 9% to 40% to cephalosporins, 13.6% to gentamicin,9% to ciprofloxacin, and 4.5% to amikacin and carbapenems. In conclusion, knowledge of the responsible bacterial flora of burn wounds, its prevalence and bacterial resistance, is of crucial importance for fast and reliable therapeutic decisions.