Bacterial Isolates From Surgical Site Infection And Their Pattern Of Antibiotics Sensitivity

• ORIGINAL ARTICLE | ISSUE DETAILS: VOL NO.1 | ISSUE NO. 2

Abstract

Background: Surgical site infection (SSI) is a widespread complication after surgery, leading to significant morbidity and mortality in patients. Improper use of antibiotics leads to an increasing frequency of SSI and the emergence of resistant bacterial strains.

Objective: To determine most common pathogens involved in SSI and to investigate their antibiotic susceptibility/ sensitivity profile.

Study design : A Qualitative Study

Duration and place of study : Mardan Medical Complex (MMC) in Mardan, Pakistan, from December 2013 to October 2014

Material and Methods: Pus specimens were obtained from the patients having SSI at Mardan Medical Complex (MMC) in Mardan, Pakistan, from December 2013 to October 2014 and were processed for microbial analysis at the Department of Pathology at Bacha Khan Medical College (BKMC) in Mardan. The specimens were inoculated on both MacConkey and 5% blood agar, and bacterial colonies were identified by gram stain, physical appearance, and biochemical tests. Furthermore, the antibiotic susceptibility test was done using the modified Kirby-Bauer disc diffusion method.

Results: Pathogenic organisms were Staphylococcus aureus (36.44%), followed by Escherichia coli (25.23%), Pseudomonas aeruginosa (13.88%), Klebsiella spp. (6.5%), Enterococcus spp. (6.5%), Acinetobacter spp. (3.7%), Proteus spp. (2.8%), Coagulase-negative staphylococci (2.8%), and other miscellaneous gram-negative rods (0.93%). About 65.7% of S. aureus were methiciline-resistant S. aureus (MRSA), while 83.3% of Klebsiella spp. and 53.8% of E. coli were Extended Spectrum Beta Lactamases (ESBL). S. aureus and Enterococcus spp. were both highly susceptible to amikacin, vancomycin, linezolid, doxycycline, and chloramphenicol. S. aureus was highly resistant to Erythromycin (65%), Penicillin (96%), Ciprofloxacin (51%), and Amoxicillin/Clavulanic Acid (65%). All the GNR, including P. aeruginosa, were highly susceptible to Imipenem, Amikacin, Tazobactam/Pipracillin, and Cefoperazone+Sulbactam. E. coli, Klebsiella spp., and other GNR were highly resistant to ampicillin, ceftriaxone, amoxicillin/clavulanic acid, cotrimoxazole, and ciprofloxacin. P. aeruginosa was also highly susceptible to Meropenem and Cefepime but showed moderate resistance to Ciprofloxacin, Ceftazidime, and Polymyxin.

Conclusion: As compared to Ceftriaxone, Ciprofloxacin, and Amoxicillin/Clavulanic Acid, Tazobactam/Pipracillin, Cefoperazone+Sulbactam, and Doxycycline showed high efficiency, and cross-resistance was found in MRSA, Ciprofloxacin, and other non-beta lactam antibiotics.