Clinicoepidemiological obervation and therapeutic targeting of multidrug Staphylococcus aureus and pseudomonas aeruginosa in Burn patients

Abstract

The present study describes epidemiology of burns in patients attending tertiary care hospital (TCH) in Faisalabad, Pakistan and role of teicoplanin and meropenem in healing of methicillin resistant Staphylococcus aureus and Pseudomonsas aeruginosa infected burns in rabbits. Both retrospective and prospective 1-year data were collected from 939 patients admitted to a Burn Unit of TCH. The results showed that median age of burn patients was 12-year with highest occurrence noted in pre-school children (≤ 4 years old) and overall incidence of burns was higher in male patients. Scalding was a major cause of burns seen in 50% of children population involving lower body parts of the body. Second-degree burns were more common (>68%) as compare to 3rd degree burns and mostly involved extremities. Above seventy percent of burns patients had 15-30% of total burn surface area (TBSA). Absolute majority of burns was due to unintentional causes, however, intentional reasons (1.5%) were primarily noted in male patients. The fatality rate was 14.5%, which was higher in females as compared to males (12.3%). The incidence burns was highest in winter and lowest in summer and burns correlated to month, degree of burn, cause of burn, TBSA% and outcome. Bacterial isolation rate was 84% in burns with highest prevalence of Pseudomonas aeruginosa followed by Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli. Male patients were more positive for bacterial cultures than females and similarly rate of isolation was higher in 3rd degree burns. Minimum inhibitory concentration of TPN and MEM were lower for MRSA and P. aeruginosa and healing score of MRSA-infected-burn wounds (in rabbit model) was swift in teicoplanin treated group. In view of certain limitations like lack of record of first aid treatment, cause(s) of death, and failure to include the patients who could not seek medical care in this data, further studies are required to investigate the prognostic factors related to outcomes in burn patients.