A Clinico – Epidemiological and Bacteriological Study of Secondary Pyoderma from a Tertiary Care Hospital in South India

Abstract

Background: Pyodermas, one of the most common clinical conditions encountered in dermatological practice in all age groups, are further classified into primary (including superficial and deep) and secondary. Bacterial infections occurring in preexisting dermatoses constitute secondary pyodermas and comprise infected eczemas/scabies/foot ulcers, surgical site infections and others. Objectives: This study was carried out to evaluate the clinical, epidemiological, and bacteriological features of secondary pyodermas in a tertiary hospital and document the various patterns of antibiotic resistance. Materials and Methods: This observational study was conducted on 101 consecutive cases of secondary pyodermas, both outpatients and inpatients, of a tertiary care hospital, over a period of 12 months. Clinicoepidemiological data was recorded, and pus samples were collected using sterile swabs for microbiological testing. Results: Diabetes mellitus was the most common comorbidity (n = 50). Of the total cases of secondary pyodermas, thirty (29.7%) were diabetic foot ulcers, and most lesions were of 2–5 cm size (n = 47), present for a duration of <1 week (n = 39), followed by 1–6 weeks (n = 35). Methicillin Susceptible Staphylococcus aureus (n = 38) among Gram-positive bacteria and Pseudomonas aeruginosa (n = 17) among Gram-negative bacteria were the most common organisms isolated. A high percentage of isolates exhibited antibiotic resistance, with Gram-positive bacteria showing resistance to Ciprofloxacin, Amoxycillin with Clavulanic acid, and Clindamycin but susceptibility to Linezolid, Cloxacillin, and Doxycycline. Among the Gram-negative isolates, there was antibiotic resistance toward most groups. Conclusion: As multi-drug resistance is an emerging concern, knowledge of associated comorbid conditions and documenting bacterial isolates and their sensitivity patterns becomes increasingly important.