Antimicrobial Susceptibility Patterns of the Bacterial Isolates in Post-Operative Wound Infections in a Tertiary Care Hospital, Kathmandu, Nepal

Abstract

Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isolates in post-operative wound infections in a tertiary care hospital in Kathmandu,Nepal. Pus swabs collected from post-operative wound infections and submitted for culture and sensitivity were included in this study. Isolation and identification of the organism was done by standard microbiological methods. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and result was interpreted as per National Committee for Clinical Laboratory Standards (NCCLS) guide lines. Of the 120 pus swabs processed for culture, 96 showed bacterial growth. Staphylococcus aureus 36 (37.5%) was the predominant gram positive isolate and Escherichia coli 24 (25%) was the major gram negative isolate .The infection was most prevalent in the age group 20-40 years. All S. aureus isolates were sensitive to aminoglycosides and vancomycin. Out of 36 S. aureus, 15 (41.66%) isolates were methicillin resistant S. aureus (MRSA). Staphylococcus epidermidis showed high resistance (50%-100%) to all antibiotics but were sensitive to vancomycin. All gram negative isolates showed high resistance against cephalexin (75%-100%) and ceftriaxone (25%-100%). Overall multi-drug resistant isolates were 66.7%. A high level of AMR was observed in gram negative bacterial isolates. Rational use of antibiotics and a regular monitoring of AMR patterns in post-operative wound infections are essential and mandatory to avert further emergence and spread of anti-microbial resistance among bacterial pathogens.

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M. Raza, A. Chander and A. Ranabhat, "Antimicrobial Susceptibility Patterns of the Bacterial Isolates in Post-Operative Wound Infections in a Tertiary Care Hospital, Kathmandu, Nepal," Open Journal of Medical Microbiology, Vol. 3 No. 3, 2013, pp. 159-163. doi: 10.4236/ojmm.2013.33024.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] J. O. Isibor, A. Oseni, A. Eyaufe, R. Osagie and A. Turay, “Incidence of Aerobic Bacteria and Candida albicans in Post-Operative Wound Infections,” African Journal of Microbiology Research, Vol. 2, No. 11, 2008, pp. 288- 291.
[2] K. B. Kirkland, J. P. Briggs, S. L. Trivetta and W. E. Wilkinson, “The Impact of Surgical Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, and Extra Costs,” Infection Control and Hospital Epidemiology, Vol. 20, No. 11, 1999, pp. 725-730. doi:10.1086/501572
[3] J. Andhoga, A. G. Macharia, I. R. Maikuma, Z. S. Wan-yonyi, B. R. Ayumba and R. Kakai, “Aerobic Pathogenic Bacteria in Post-Operative Wounds at Moi Teaching and Referral Hospital,” East African Medical Journal, Vol. 79, No. 12, 2002, pp. 640-644. doi:10.4314/eamj.v79i12.8671
[4] A. F. Moges, A. Genetu and G. Mengistu, “Antibiotics Sensitivity of Common Bacterial Pathogens in Urinary Tract Infections at Gondar Hospital, Ethiopia,” East African Medical Journal, Vol. 79, No. 3, 2002, pp. 140-142. doi:10.4314/eamj.v79i3.8893
[5] F. Biadglegne, B. Abera, A. Alem and B. Anagaw, “Bacterial Isolates from Wound Infections and Their Antimicrobial Susceptibility Patterns in Felege Hiwot Referral Hospital, North West Ethiopia,” Ethiopian Journal of Health Sciences, Vol. 19, No.3, 2009, pp. 173-177.
[6] B. Roma, S. Worku, S. T. Marium and N. Langeland, “Antimicrobial Susceptibility Pattern of Shigella Isolates in Awassa,” Ethiopian Journal of Health Development, Vol. 14, No. 2, 2000, pp. 149-154. doi:10.4314/ejhd.v14i2.9914
[7] S. Malik, A. Gupta, K. P. Singh, J. Agarwal and M. Singh, “Antibiogram of Aerobic Bacterial Isolates from Post-Operative Wound Infections at a Tertiary Care Hospital in India,” Journal of Infectious Diseases Antimicrobial Agents, Vol. 28, No. 1, 2011, pp. 45-51.
[8] M. Arya, P. K. Arya, D. Biswas, R. Prasad, “Antimicrobial Susceptibility Pattern of Bacterial Isolates from Post-Operative Wound Infections,” Indian Journal of Pathology and Microbiology, Vol. 48, No. 2, 2005, pp. 266-269.
[9] S. A. Ali, S. M. Tahir, A. S. Memon and N. A. Shaikh, “Pattern of Pathogens and Their Sensitivity Isolated from Superficial Surgical Site Infections in a Tertiary Care Hospital,” Journal of Ayub Medical College Abbottabad, Vol. 21, No. 2, 2009, pp. 80-82.
[10] A. Giacometti, O. Cirioni, A. M. Schimizzi, M. S. Del Prete, F. Barchiesi, M. M. D’Errico, E. Petrelli and G. Scalise, “Epidemiology and Microbiology of Surgical Wound Infections,” Journal of Clinical Microbiology, Vol. 38, No. 2, 2000, pp. 918-922.
[11] A. A. Adegoke, T. Mvuyo, A. I. Okoh and J. Steve, “Studies on Multiple Antibiotic Resistant Bacteria Isolated from Surgical Site Infection,” Scientific Research and Essays, Vol. 5, No. 24, 2010, pp. 3876-3881.
[12] J. R. Anguzu and D. Olila, “Drug Sensitivity Patterns of Bacterial Isolates from Septic Post-Operative Wounds in a Regional Referral Hospital in Uganda,” African Health Sciences, Vol. 7, No. 3, 2007, pp. 148-154.
[13] B. R. Giri, H. P. Pant, P. R. Shankar, C. T. Sreeramareddy, P. K. Sen, “Surgical Site Infection and Antibiotics Use in a Tertiary Care Hospital in Nepal,’ Journal of Pakistan Medical Association, Vol. 58, No. 3, 2008, pp. 148-151.
[14] M. R. Banjara, A. P. Sharma, A. B. Joshi, N. R. Tuladhar, P. Ghimire and D. R. Bhatta, “Surgical Wound Infections in Patients of Tribhuvan University Teaching Hospital, Journal of Nepal Health Research Council, Vol. 1, No. 2, 2003, pp. 41-45.
[15] M. Cheesbrough, “District Laboratory Practice in Tropical Countries Part 2,” Cambridge University Press, Cambridge, 2000.
[16] A. W. Bauer, M. Kirby, J. D. Sheris and M. Turch, “Antibiotic Susceptibility Testing by Standard Single Disc Method,” American Journal of Clinical Pathology, Vol. 45, No. 4, 1966, pp. 493-496.
[17] National Committee for Clinical Laboratory Standards, “Performance Standards for Antimicrobial Disc Susceptibility Testing,” 2004.
[18] A. P. Magiorakos, A. Srinivasan, R. B. Carey, Y. Carmeli, M. E. Falagas, C. G. Giske, et al., “Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Bacteria: An International Expert Proposal for Interim Standard Definitions for Acquired Resistance,” Clinical Microbiology Infection, Vol. 18, No. 3, 2012, pp. 268-281. doi:10.1111/j.1469-0691.2011.03570.x
[19] S. S. Taiwo, A. B. Okesina and B. A. Onile, “Invitro Antimicrobial Susceptibility Pattern of Bacterial Isolates from Wound Infections in University of Ilorin Teaching Hospital,” African Journal of Clinical and Experimental Microbiology, Vol. 3, No. 1, 2002, pp. 6-10. doi:10.4314/ajcem.v3i1.7342
[20] F. T. Ogunsola, O. Odeyebo, K. C. Iregbu, A. O. Coker and A. Adetunji, “A Review of Nosocomial Infection at the Lagos University Teaching Hospital: Problems and Strategies for Improvement,” Journal of Nigerian Infection Control Association, Vol. 1, No. 1, 1998, pp. 11-13.
[21] R. L. Nichols, “Surgical Wound Infection,” American Journal of Medicine, Vol. 91, No. 3, 1991, pp. S54-S64. doi:10.1016/0002-9343(91)90344-W
[22] S. L. Gorbach and J. G. Bartlett, “Anaerobic Infections,” New England Journal of Medicine, Vol. 290, No. 21, 1974, pp. 1177-1184. doi:10.1056/NEJM197405232902106
[23] S. O. Samuel, O. O. Kayode, O. I. Musa, G. C. Nwigwe, A. O. Aboderin, T. A. T. Salami and S. S. Taiwo, “Nosocomial Infections and the Challenges of Control in Developing Countries,” African Journal of Clinical and Experimental Microbiology, Vol. 11, No. 2, 2010, pp. 102-110. doi:10.4314/ajcem.v11i2.53916
[24] J. L. Walson, B. Marshall, B. M. Pokhrel, K. K. Kafle and S. B. Levy, “Carriage of Antibiotic-Resistant Fecal Bacteria in Nepal Reflects Proximity to Kathmandu,” Journal of Infectious Diseases, Vol. 184, No. 9, 2001, pp. 1163-1169. doi:10.1086/323647
[25] S. B. Levy, B. Marshall, S. Schluederberg, D. Rowse and J. Davis, “High Frequency of Antimicrobial Resistance in Human Fecal Flora,” Antimicrobial Agents and Chemotherapy, Vol. 32, No. 12, 1988, pp. 1801-1805. doi:10.1128/AAC.32.12.1801

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