Aditya Wardhana1,2,3, Radhianie Djan1,2, Zainul Halim1
1Burn Unit, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia , Jakarta Pusat/ DKI Jakarta, Indonesia, 2Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Jakarta Pusat/ DKI Jakarta, Indonesia, 3Plastic and Reconstructive Surgery Division, Department of Surgery, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, Jakarta Pusat/ DKI Jakarta, Indonesia
Background: Infection is major cause of mortality and morbidity among burn patients. Effective measure of reducing infection is routine monitoring of the bacterial infection and antimicrobial susceptibility patterns at burn unit. This will help in creating burn center-specific protocol for empirical antibiotic therapy.
Method: A retrospective, descriptive study was conducted in Cipto Mangunkusumo Hospital (RSCM) Burn Unit between September-November 2016. The data collected include bacterial isolate culture, antimicrobial susceptibility spectrum, and the number of burn patients diagnosed with sepsis.
Result: 36 patients were identified with bacterial pattern changed continuously between Klebsiella pneumonia (17%), Pseudomonas Aeruginosa (12%), and Acinetobacter baumannii (11%). High resistance rates are found in 10 antimicrobials spectrum, particularly cephalosporin. Only Carbapenem, Aminoglycosides and Tigecycline are sensitive to these bacteria. Fourteen patients were diagnosed with sepsis (38,9%), 10 were deceased. Two major sepsis-causing bacteria were P. aeruginosa (33,3%) and K. pneumoniae (28,9%).
Conclusions: Etiologic agents of burn infection in our setting alternated continuously every month. Almost all bacterial isolates are classified as multi-drug resistant, with high resistance rates to our empirical therapy (ceftriaxone) leading to outbreak of sepsis and mortality rates. Combination of Carbapenem (Imipenem, Meropenem and Doripenem) and Aminoglycosides (Amikacin) are selected as empirical therapy.
Burn infection, antibiotic susceptibility, multi-drug resistant, sepsis
Dr. Radhianie Djan is currently a general practitioner who works as a research assistant in Burn Unit, Plastic Reconstructive Division in Cipto Mangunkusumo National General Hospital.