Epidemiological profile and antibiotic susceptibility of Pseudomonas areuginosa isolates within the hospitalized burned patient

Pseudomonas aeruginosa plays a predominant role as an etiological agent involved in serious infections in burned patients. Treatment of these infections is frequently complicated by antibiotic resistance, a problem that has been increasing in recent years.

The objective of this study is to analyse the epidemiological profile and antibiotic susceptibility of P. aeruginosa isolates within the burned patients admitted to our intensive care burn department. During a period of 4 years (2000–2003), 828 burn patients were admitted. Thermal burn (70%) was the most frequent burn, followed by electric (27%) and chemical (3%) burn. The population examined had an average burn size of 44% of the body surface with the mean age of 34 ± 17 years. One hundred and seventy strains of P. aeruginosa were isolated in different samples from burned patients. These isolates were identified using standard microbiological techniques and their antibiotic susceptibility was determined using the disk diffusion method recommended by the French Society of Microbiology.

Over the study period, P. aeruginosa was isolated mainly from cutaneous superinfections (59%), urine (21.7%), blood culture (14.8%) and venous catheter culture (4.7%). P. aeruginosa was the most common isolate from cutaneous pus (22.9%). Bacteremia were mainly caused by Acinetobacter baumannii (16.5%) and Staphylococcus aureus (15.5%). P. aeruginosa was only isolated in 8.2% of bacteremia. The survey of antibiotic susceptibility of P. aeruginosa showed that 60.9% of strains were resistant to piperacillin, 53.4% to ceftazidime, 37.6% to imipenem, 70.6% to cefsulodine, 59.3% to tobramycin, 80% to gentamicin, 62.4% to amikacin and 53.4% to ciprofloxacin.

During this study period, a high resistance to antibiotics of P. aeruginosa was observed. It is necessary to implement urgent measures to prevent the spreading of these multi-resistant strains. These measures include: sensible limitation of the use of antimicrobial agent, strict disinfection and hygienic procedures.