Antibacterial resistance of burn infections in Al-Hussain Teaching Hospital/Thi-Qar Province

  • Rua Abbas Naser Al-Hamdy Department of Clinical and Laboratory Sciences/ College of Pharmacy/ Thi-Qar University
Keywords: Burn infection, antibacterial resistance


  Burn infection is a main cause of morbidity and mortality. Burn patients are more susceptible to get infections in comparison with other patients. This study has been conducted to determine bacterial pathogens frequently causing burn infections and their antimicrobial resistance patterns. This study was carried out on thirty  patients admitted to the burn unit at Al-Hussain Teaching Hospital/Thi-Qar Province during a five-month period from August 2015 to December 2015. A swab has been taken from each patient. Antibiotic sensitivity was performed by the disc diffusion method. Tested antibiotics used in this study were ampicillin, augmentin, ciprofloxacin, cefepime, ceftazidime, ceftriaxone, gentamicin, imipenem, tobramycin, vancomycin, levofloxacin, piperacillin, ticarcillin-clavulanic acid, netlimicin, amikacin, chloramphenicol, ticarcillin, , tetracycline, Co-Trimethaxazole and rifampicin. Thirty four bacterial isolates were obtained from thirty swabs. We found that the most predominant bacterial isolate was Pseudomonasspp. (49%), followed by Klebsiella spp. (21%), Staphylococcusspp. (12%), Escherichia coli (E.coli) (6%), Proteus spp. (6%), Acinetobacter spp. (3%) and Enterococcus spp. (3%). Polymicrobial infection was obtained in (13.3%) of patients. All isolated pathogens were multi-drug resistant.Acinetobacter spp. and Enterococcus spp. were the most resistant pathogens (100%), followed by E. coli (90.47%), Staphylococcusspp. (79.17%) , Klebsiella spp. (68.75%), Proteus spp.(68.75%) and Pseudomonas spp. (65.88%). Gram-positive bacteria showed complete resistance against ampicillin, while Gram-negative bacteria showed high resistance against augmentin, cefepime, ceftriaxone, tobramycin ,piperacillin, ticarcillin-clavulanic acid, amikacin, chloramphenicol, and tetracycline. Non-significant difference was found among the tested antibiotics concerning resistance (P value >0.005). However ciprofloxacin, gentamicin and imipenem were significantly effective against most types of pathogens compared to all tested antibiotics (P value <0.005). In conclusion Pseudomonas spp. were the most predominant pathogen. All isolated pathogens were multi-drug resistance which is an emerging problem. We need more periodic studies to evaluate bacterial resistance from time to time to help in treatment policy


- Ekrami A, Kalantar E. Bacterial infections in burn patients at a burn hospital in Iran. Indian Journal of Medical Research. 2007;126(6):541.

- Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clinical microbiology reviews. 2006;19(2):403-34.

- Murray C, Hospenthal D. Burn wound infections. Medscape http://emedicine medscape com/article/213595-overview (accessed 3rd December 2011). 2008.

- Agnihotri N, Gupta V, Joshi R. Aerobic bacterial isolates from burn wound infections and their antibiograms—a five-year study. Burns. 2004;30(3):241-3.

- Abubakar E-MM. The use of Psidium guajava Linn. in treating wound, skin and soft tissue infections. Scientific Research and Essays. 2009;4(6):605-11.

- Herndon DN. Total burn care: Elsevier Health Sciences; 2007.

- Tancheva D, Hadjiiski O. Effect of early nutritional support on clinical course and septic complications in patients with severe burns. Annals of burns and fire disasters. 2005;18(2):74.

- Rahbar M, Gra Agaji R, Hashemi S. Nosocomial blood stream infections in Imam Khomeini Hospital, Urmia, Islamic Republic of Iran, 1999-2001. 2005.

- Ansermino M, Hemsley C. ABC of burns: intensive care management and control of infection. BMJ: British Medical Journal. 2004;329(7459):220.

- Revathi G, Puri J, Jain B. Bacteriology of burns. Burns. 1998;24(4):347-9.

- Weinstein RA, Mayhall CG. The epidemiology of burn wound infections: then and now. Clinical Infectious Diseases. 2003;37(4):543-50.

- Clark NM, Patterson J, Lynch JP. Antimicrobial resistance among gram-negative organisms in the intensive care unit. Current opinion in critical care. 2003;9(5):413-23.

- Edwards-Jones V, Greenwood JE, Group MBR. What’s new in burn microbiology?: James Laing memorial prize essay 2000. Burns. 2003;29(1):15-24.

- Rennie RP, Jones RN, Mutnick AH, Group SPS. Occurrence and antimicrobial susceptibility patterns of pathogens isolated from skin and soft tissue infections: report from the SENTRY Antimicrobial Surveillance Program (United States and Canada, 2000). Diagnostic microbiology and infectious disease. 2003;45(4):287-93.

- Karlowsky JA, Jones ME, Draghi DC, Thornsberry C, Sahm DF, Volturo GA. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002. Annals of clinical microbiology and antimicrobials. 2004;3(1):1.

- Retty A, Danil F, Aice S. Balley and Scott's of Diagnostic microbiology. Press, Houston, Texas; 2007.

- teve K, Dennis S. Microbiology. A Photographic Atlas for Laboratory. Ed Pearson Education. 2001.

- Wayne P. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing. 2007;17.

- Othman N. Epidemiology of burn injuries in Sulaymaniyah province of Iraq: University of Nottingham; 2010.

- Dash M, Misra P, Routaray S. Bacteriological profile and antibiogram of aerobic burn wound isolates in a tertiary care hospital, Odisha, India. Int J Med Med Sci. 2013;3(5):460-3.

- Magnet M, Arongozeb M, Khan GM, Ahmed Z. Isolation and identification of different bacteria from different types of burn wound infections and study their antimicrobial sensitivity pattern. Int J Res Appl, Nat Soc Sci. 2013;1(3):125-32.

- Rastegar Lari A, Alaghehbandan R, Akhlaghi L. Burn wound infections and antimicrobial resistance in tehran, iran: an increasing problem. infection. 2005;12:13.

- Alghalibi S, Humaid A, Alshaibani E, Alhamzy E. Microorganisms associated with burn wound infection in Sana’a, Yemen. Egypt. Acad. J biolog Sci. 2011;3(1):19-25.

- Abbas HA, El-Masry EM, Shaker GH, Mohsen I. BACTERIAL ETIOLOGY AND ANTIMICROBIAL RESISTANCE OF BURN WOUND INFECTIONS IN A BURN UNIT IN HEHIA GENERAL HOSPITAL IN EGYPT. International Journal of Biological & Pharmaceutical Research. 2013(4):1251.

- Yasidi BM, Akawu DB, Oihoma OJ, Bara JY, Mohammed UH, Mohammed GN, et al. Retrospective Analysis of Bacterial Pathogens Isolated from Wound Infections at a Tertiary Hospital in Nguru, Yobe State Nigeria. American Journal of Biomedical and Life Sciences. 2015;3(1):1-6.

- Otta S, Dash JK, Swain B. Aerobic bacteriology of burn wound infections. CHRISMED Journal of Health and Research. 2015;2(4):337.

- Bayram Y, Parlak M, Aypak C, Bayram I. Three-year review of bacteriological profile and antibiogram of burn wound isolates in Van, Turkey. International journal of medical sciences. 2013;10(1):19.

- Macedo JLSd, Santos JB. Bacterial and fungal colonization of burn wounds. Memórias do Instituto Oswaldo Cruz. 2005;100(5):535-9

- Ameen IA, Salih HA, Abaas AT. In vitro antibacterial properties of garlic extract against some pathogenic bacteria isolated from burn unit. Journal of Thi-Qar Sciences. 2015;5(3):17-21.

- Othman N, Babakir-Mina M, Noori CK, Rashid PY. Pseudomonas aeruginosa infection in burn patients in Sulaimaniyah, Iraq: risk factors and antibiotic resistance rates. The Journal of Infection in Developing Countries. 2014;8(11):1498-502.

- Melake NA, Eissa NA, Keshk TF, Sleem AS. Prevalence of multidrug-resistant bacteria isolated from patients with burn infection. Menoufia Medical Journal. 2015;28(3):677.