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

Original Article

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.