TMSS Medical College Journal

Background: Wound infection is one of the major problems in surgical cases that are caused and aggravated by the invasion of pathogenic organisms. Information on local pathogens and sensitivity to antimicrobial agents is crucial for successful treatment of wounds. Objective: To identify local pathogens and determine antimicrobial susceptibility pattern of isolated bacterial from wound infection at Rafatullah Community Hospital, Bogra. Methodology: This cross sectional study was conducted among patients with wound infection visiting Rafatullah Community Hospital, Bogra, from May2014 to December 2015. Wound swab was collected using sterile cotton swabs and processed for bacterial isolation and susceptibility testing to antimicrobial agents following standard bacteriological techniques. Biochemical tests were done to identify the species of the organisms. Sensitivity testing was done using Kirby- Baur disk diffusion method against 15 classes of antimicrobials. The data was analyzed for descriptive statistics using Microsoft Excel. Results: In this study 122 bacterial isolates were recovered from 155 specimens showing an isolation rate of 78.6%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 36 (29.5%) followed by Escherichia coli 34 (27.9%), Enterobacter species 24 (19.7%), Klebsiella species 14 (11.5%), Pseudomonas species 10 (8.2%) and Enterococeal species 04(3.3%). All isolates showed high frequency of resistance to amoxycillin, amoxicillin-clavulanic acid, co-trimoxazole, and cephradine. Conclusion: On in vitro sensitivity testing, amoxycillin, amoxicillin-clavulanic acid, co-trimoxazole, and cephradine were the least effective. Moxifloxacin, gentamicin, amikacin and ciprofloxacin were the most effective antibiotics for all isolates.

The primary function of intact skin is to control microbial populations that live on the skin surface and to prevent underlying tissue from becoming colonized and invaded by potential pathogens!. Exposure of subcutaneous tissue following a loss of skin integrity (i.e. wound) provides a moist, warm, and nutritious environment that is conducive to microbial colonization and proliferation. Since wound colonization is most frequently poly-microbial, involving numerous microorganisms that are potentially pathogenic, any wound is at some risk of becoming infected2. Infection in wound constitutes a major barrier to healing and can have an adverse impact on the patient's quality of life as well as on the healing rate of the wound. Infected wounds are likely to be more painful, hypersensitive and odorous, resulting in increased discomfort and inconvenience for the patient’. The prevalent organisms that have been associated with wound infection include Staphylococcus aureus which from various studies have been found to account for 20-40% and Pseudomonas aeruginosa 5-15% of the nosocomial infection, with infection mainly following surgery and burns. Other pathogens such as Enterobacter species, Klebsiella species, Enterococci species are members of the Enterobacteriaceae have been implicated, especially in immune compromised patients and following abdominal surgery.