Antimicrobial Resistance Patterns of Wound/Pus Isolates in a Tertiary Care Setting in Bangladesh.
Abstract
Introduction: Wound infection is one of the common and important complication of wound. When the infection is serious
or the host is compromised, it needs prolong stay in hospital that results significant increase in costs, morbidity, and
mortality.
Objective: Bacteria causing wound infection and their sensitivity pattern vary from place to place and it changes
frequently over times. Inappropriate use of antimicrobial agents for management of wound infection leads to emergence
and spread of drug resistance among the pathogenic bacteria. This study aims to highlights the distribution of bacterial
isolates and their antibiotic resistance pattern from wound/pus sample.
Materials and Methods: A retrospective analysis of 425 clinical wound/pus samples were received from patient who were
visited in outpatient department and were admitted in TMSS Medical College & Rafatullah community Hospital, Bogura
from January 2023 to December 2023. The study was conducted at the Microbiology laboratory of same hospital in
Bogura. Bacterial isolates were identified by standard conventional microbial technique and antibiotic susceptibility was
carried out by modified Kirby-Bauer disc diffusion method.
Results: Among 425 patients 153 (36%) were aged 21 to 40 years and 152 (35.76%) were 41 to 60 years. Male (58.12%)
were predominant than female (41.88%). Growth was seen in 375 (88.23%) samples out of 425. Out of 375 positive
samples, 315 (84%) samples yielded single isolates whereas 60 (16%) samples yielded two isolates, and total isolates of
bacteria was 435 in number. Among the isolates, Gram-negative bacilli (GNB) 321 (73.79%) were predominant than
Gram-positive cocci (GPC) 114 (26.21%). Klebsiella spp. was highest number about 133 (30.57%) followed by
Staphylococcus. aureus109 (25.06%), Pseudomonas 99 (22.76%), then E. coli 51 (11.72%). GNB were highly sensitive to
piperacillin-tazobactam combination (85%-100%), gentamycin (54%-90%), amikacin (70-85%) and meropenem
(68%-100%) and less sensitive to linezolid (05%-20%), vancomycin (0%-35%), 3 and 4" generation of cephalosporin
(10%-40%). Staphylococcus aureus was highly sensitive to co-trimoxazole (82%), vancomycin (74%), linezolid (66%),
tigecycline (94%), meropenem (94%), piperacillin-tazobactam combination (95%), amikacin (95%) and less sensitive to
ceftazidime (17%), colistin (13%), and aztreonam (14%).
Conclusion: The study revealed the most common organism in pus sample was Klebsiella spp. followed by
Staphylococcus aureus than Pseudomonas. So, empiric use of antibiotics based on current antibiogram of wound infection
of this hospital and strictly monitoring antibiotic stewardship programs in the hospital.
Keywords
Gram-negative bacilli
Gram-positive cocci
Antibiotic sensitivity test.
Introduction
Wound infection is a common problem in hospitals throughout the world and is caused mainly by bacteria’ A break in skin or other body tissues caused by injury or surgical incision leads to wound. When bacteria or another pathogen enter, multiply and colonize within the wound, it became infected. These pathogens are either monomicrobial or polymicrobial with mixture of aerobic or anaerobic organisms. Among the monomicrobial species Staphylococcus aureus and Staphylococcus epidermidis are the most common organisms likely to be encountered followed by Gram-negative bacilli, such as Klebsiella species,