Bacterial Profile of Paediatric Burn Wounds and their Antibacterial Sensitivity Patterns

Objective: To determine the bacterial profile of paediatric burn wounds and their antibacterial spectrum in order to understand and help in planning for better antibiotic selection and overall management. Methods: Retrospective review of prospectively collected data of paediatric age burn patients at Habib Burn Centre Peshawar between January 2013 and December 2015. Culture& sensitivity tests were performed using wound surface swabs and tissue culture over the three-year period. Their results were collected in a predesigned digital form. Statistical analysis was done and results plotted. Results: 1204 (67.8%) patients tested positive with the commonest bacterial isolate of coagulase negative Staphylococcus species (14.5%, n=258), followed in frequency by E. coli (10.7%, n=190), Enterobacter species (9.9%, n=176) and Pseudomonas species (9.6%, n=170). Multidrug resistant Staphylococcus aureus (MRSA) was found in 114 (6.4%) of cases. The most effective antibacterial was Imipenem with a susceptibility rate of 64.3% in 1143 patients. This was followed in efficacy by Tigecycline (63.9%) and Ofloxacin (54.3%). The least effective antibacterial was Cephradine with effectiveness of only 25.4%. Linezolid and Vancomycin were the most effective against MRSA at 91.2% and 100% efficacy. Conclusions: Resistance to antibiotics is rapidly increasing in our community and burn wounds are frequently infected by these multidrug resistant organisms. Careful antibiotic selection and effective control of these strains can be translated into lower morbidity and mortality for these patients.