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


Radhianie Djan1,3*, Zainul Halim1, Aditya Wardhana1,2,3


1 Burn Unit, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
2 Plastic and Reconstructive Surgery Division, Department of Surgery, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
3 Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

*Corresponding author: Burn Unit, Plastic and Reconstructive Surgery Division, Department of Surgery, Cipto Mangunkusumo National General Hospital, Jalan Pangeran Diponegoro No. 71, Second Floor CMU 3 Building, Jakarta, Indonesia. Tel.: +62 81291111392; email address: radhianiedjan@gmail.com

ABSTRACT
Background: 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 center-specific empirical antibiotic therapy protocol. 

Method: 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. 

Results: 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%). 

Conclusion: 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.

Keywords: burn infection, antibiotic susceptibility, multi-drug resistance, sepsis

Bacterial and Antimicrobial Susceptibility Profile, and Prevalence of Sepsis Among Burn Patients at the Burn Unit of Cipto Mangunkusumo Hospital