Biofilm-associated Multi-drug Resistant Bacteria Among Burn Wound Infections: A Cross-sectional Study

Introduction: Biofilm is an organized colony of bacterial cells that are adjoined by a self-produced polymeric matrix.These biofilms play a role in the pathophysiology and clinical manifestations of many illnesses, often leading to treatment failures.Microorganisms that can produce biofilm express high resistance to antimicrobial agents compared to non-biofilm-producing microbes.The study seeks to evaluate the rate of biofilm-producing aerobic bacteria in burn wounds and determine the rate of multi-drug resistant bacteria from burn wound infections. Materials and Methods:The study was a cross-sectional study conducted at the Department of Microbiology at the Maharishi Markandeshwar Institute of Medical Science and Research (MMIMSR) Mullana, Ambala, Haryana.In this study, a total of 50 burn wound swab samples were collected from patients along with their detailed clinical history and proceeded further for bacterial identification by standard microbiological methods.An antimicrobial susceptibility test was performed for all bacterial isolates using the disc diffusion method of the modified Kirby-Bauer technique using Mueller Hinton agar plates and commercially available antimicrobial discs.Biofilm-forming bacteria were identified using the modified Congo red agar method and the Tube Adherence method.Results: 56.8% of the isolates obtained were biofilm-forming bacteria.Out of the biofilm-producing bacteria, 48% were multi-drug resistant.Marked resistance was seen for commonly used antibiotics like Quinolones, Cephalosporins, and Cotrimoxazole.Staphylococcus aureus isolates were resistant to Ofloxacin, Penicillin G, and Amikacin; Klebsiella spp.isolates were highly resistant to Ampicillin, Ceftazidime, Trimethoprimsulfamethoxazole, Tetracycline, and Chloramphenicol; Pseudomonas aeruginosa isolates were highly resistant to Trimethoprimsulfamethoxazole; Acinetobacter spp isolates were resistant to Cefotaxime, Ceftriaxone, Cefixime and Trimethoprim-sulfamethoxazole.For Gram-positive bacteria, Staphylococcus aureus showed 100% susceptibility to Linezolid, Vancomycin, and Netilmycin while coagulase-negative Staphylococci (CoNS) isolates were sensitive to all antibiotics.For Gram-negative bacteria, carbapenem antibiotics showed the highest sensitivity to Klebsiella, Proteus, Pseudomonas aeruginosa, and Acinetobacter spp. Conclusion:The study calls attention to the increasing rate of multi-drug resistant bacteria in burn wound infections and the need for effective infection control measures and treatment methods to combat these biofilm-forming multi-drug resistant bacteria.