The Prevalence Of Infection, Microbiologic Profile And Antimicrobial Sensitivity Pattern Of Burn Wounds As Seen At Kenyatta National Hospital

Abstract

Burn injuries are one of the most common and devastating causes of trauma, more so in developing countries. A majority of mortalities from burn injuries is due to sepsis. Infection causing microorganisms in any burn facility change with time with emergence of new drug resistant strains. Therefore, heightened surveillance of burn wound microorganisms in burn facilities along with their susceptibility patterns is essential. Objective: The aim of this study was to determine the prevalence and microbiologic profile of wound infection and antimicrobial sensitivity of burn patients admitted at Kenyatta National Hospital. Materials and Methods: This was a cross sectional study involving burn patients admitted in KNH burns unit and ward 4D carried out over a period of three months from March 2018 to May 2018. Swabs were collected using the Levine technique for microscopy culture and sensitivity from the burn wounds of the patients who met the inclusion criteria for the study. The results of were then correlated with the site, size, type and duration of the burns and the patients characteristics. Data was be collected using a predesigned questionnaire and analyzed using IBM SPSS version 21. Means and standard deviations or medians and ranges were be calculated for continuous data while percentages were be calculated for categorical data. The microbiologic pattern was be determined by calculating the frequency of occurrence of types of microorganisms. The antibiotic sensitivity pattern of micro-organisms cultured from burn wounds was be determined by calculating proportions of microorganisms above established cut-off values for antibiotic sensitivity. Statistical significance was determined using a p value cut-off of < 0.05. xv Results: 80 patients participated in the study. The infection rate among these patients was at 88.8% (n = 71). In the plastic surgical ward, the infection rate was 90.7% (n = 41) while among patients from the burns unit, the infection rate was 84.6% (n = 22). The microorganisms cultured included: Proteus mirabillis at 34.2% (n = 26), Staphylococcus aureas at 18.8% (n = 15) and Pseudomonas aeruginosa at 10.5% (n = 8) these bacteria were cultured from both plastic surgical ward and the burns unit. Bacteria cultured only from the burns unit included, Staphylococcus pseudointermedius at 10.5% (n = 8), Escherichia coli at 7.9% (n = 6) and Actinobacter baumanii complex at 6.6% (n = 5). The cultured bacteria was tested against various antibiotics with widely varying sensitivity and resistance these antibiotics. Conclusion: There is a high prevalence of infection among burn wounds of patients admitted at KNH. There is variation in bacterial sensitivity to the antibiotics tested against, with a high level of resistance to some of the commonly used antibiotics in KNH.