Bacterial and antimicrobial susceptibility profile and the prevalence of sepsis among burn patients at the burn unit of Cipto Mangunkusumo Hospital.

Abstract

Infection is a major cause of mortality and morbidity among burn patients. An effective measure to reduce infection is routine monitoring of bacterial infection and antimicrobial susceptibility patterns at the burn unit. This will help to create a burn centre-specific empirical antibiotic therapy protocol. A retrospective, descriptive study was conducted at the Cipto Mangunkusumo Hospital (RSCM) Burn Unit between September-November 2016. Data regarding bacterial culture isolates, antimicrobial susceptibility spectrum, and the number of burn patients diagnosed with sepsis were collected. There were 36 patients with positive bacterial cultures, with the isolates changing continuously between Klebsiella pneumonia (17%), Pseudomonas Aeruginosa (12%) and Acinetobacter baumannii (11%). High resistance was found for 10 antimicrobials, particularly cephalosporins. The three bacteria were only sensitive to carbapenem, aminoglycosides and tigecycline. Fourteen patients were diagnosed with sepsis (38.9%), 10 died. Two major sepsis-causing bacteria were P. aeruginosa (33.3%) and K. pneumoniae (28.9%). Bacterial isolates in our setting changed every month. Almost all bacterial isolates are multi-drug resistant, highly resistant to the empirical therapy given (ceftriaxone), leading to outbreaks of sepsis and increased mortality rates. Carbapenem (imipenem, meropenem and doripenem) and aminoglycosides (amikacin) combination was the selected empirical therapy.