Antibiotic Sensitivity Pattern of Pathogens Isolated from Pus Culture- A Tertiary Care Hospital Based Study

Abstract

Background: Microbial pathogens cause human skin and soft tissue infections (SSTI) and surgical site infections (SSI) after surgical procedures. These can result in the production of pus, yellowish fluid comprising of dead WBCs and cellular debris. The microorganisms responsible for pus production vary greatly in relation to their spectrum of prevalence in different hospital and also in their antibiotic sensitivity. Further, the antibiotic sensitivity also changes because of the emergence of resistant strains. It is therefore, important that the common bacterial pathogens causing infection in a particular hospital and their sensitivity should be known. This will help in the choice of prophylactic antibiotic and in initiating the empirical antibiotic prescription for the infected cases before the culture sensitivity report is made available which takes about 2-3 days.
 Objective: To identify the spectrum of aerobic bacteria which are responsible for SSTI and SSI and their antibiotic sensitivity pattern.
 Method: This cross sectional hospital based study was conducted in Nepalgunj Medical College and Teaching Hospital (NGMCTH), Kohalpur from January 2019 to November 2019. These pus swabs were obtained from the Department of Surgery and Department of Gynaecology & Obstretics. Samples were cultured in the Microbiology laboratory of NGMCTH, Kohalpur. Identification and characterization of isolates were performed on the basis of Gram staining and cultural characteristics. Antibiotic sensitivity test was performed in vitro by Bauer-Kirby method. Collected data were statistically analyzed using SPSS 20.0 and Microsoft Excel 2015.
 Results: During the study period, a total number of 311 pus swabs were obtained among which only 164 (52.73%) pus swab showed bacterial growth. Out of 164 pus swabs, 150 pus swabs yielded monomicrobial growth (150 bacterial isolates) and 14 pus swabs yielded polymicrobial growth (33 bacterial isolates). Gram Negative Bacteria (60.1%) was more prevalent than Gram Positive Bacteria (39.9%). Combined together, the most common isolate was S. aureus (36.1%) followed by E.coli (24.0%), Klebsiella (14.2%), Enterobacter (11.5%), Pseudomonas (9.8%), S. pyogenes (3.3%) and Proteus (1.1%). S. aureus was highly sensitive to Doxycycline (90.6%), Chloramphenicol (81.5%), Amikacin (79.5%) and Ceftraixone (72.7%). S. pyogenes showed 100% sensitivity to Cefexime, Amikacin, Chloramphenicol, Azithromycin and 80% sensitivity to Doxycycline. Similarly, most common gram negative isolate E.coli showed higher sensitivity to Chloramphenicol(71.4%) and Amikacin (66.7%) , Klebsiella showed higher sensitivity to Doxycycline(92.3%), Gentamicin(87.5%) and Amikacin (81.0%), Enterobacter showed higher sensitivity to Amikacin(90.9%) and Pseudomonas was highly sensitive to Chloramphenicol (71.4%) and Amikacin (66.7%). Piperacillin, Amikacin, Gentamicin, Ofloxacin and Ceftriaxone showed 100% sensitivity to Proteus spp. Amoxyclav, Cefepime and Cefexime (except in S. pyogenes) showed least sensitivity in both gram negative and gram positive bacterial isolates.
 Conclusion: In our study, the most common isolate wasS. aureus. Amikacin, as a single drug was found to be effective for empirical therapy of both gram negative and gram positive bacteria whereas Doxycycline and Amikacin was found effective in gram positive isolates. Amoxyclav and Cefepimewas commonly resistant in all bacterial isolates.

Characterization and Antibiotic Susceptibility of Bacteria Isolated from Clinical Specimens in Rajshahi, Bangladesh

“…Even in a blood specimen, the count of E. coli was the highest (n=41, 36.28%) where Simkhada et al in 2016 described Salmonella Paratyphi A (n=26, 54.17%) as the leading etiological agent in blood-borne infections and E. coli is only 6.25% (n=3) (22). The most common isolate in pus specimen was Staphylococcus aureus (n=29, 58%) followed by E. coli (n=8, 16%) which correlates with previous studies (18,23). Although in some instances, E. coli was the most frequently detected bacteria in pus specimens (6,21).…”

“…Children are easily getting infected due to contaminated water and food as well as by contacting contaminated surfaces or animals that may carry certain bacteria like Salmonella spp. (16)(17)(18). Most positive cases were reported in summer-rainy seasons except in pus where the highest count was observed in late autumn.…”

Identification of Bacterial Isolates and Their Antimicrobial Susceptibility Pattern from Wound/Pus Sample in a Tertiary Care Hospital, Gwalior, India

“…It has been linked to more trauma care, longer hospitals stay, and treatment. The results revealed 58.28% positivity rate of total sample that correlate with the studies of Rai et al 23 (59%), Trojan et al 8 (60.1%), and Khanam et al 21 (61.8%); however, it exceeded a study conducted by Singh et al 13 (52.73%) and less than a research conducted by Muluye et al 7 (70.2%) and Batra et al 24 (85.02%).…”

Spectrum of all microorganism isolated from surgical site infection and their antimicrobial susceptibility profile

“…The predominant bacteria isolate recovered in the study included Staphylococcus SPP 44 isolates (30.99%) followed by E coli 41 isolates (28.87%) Klebsiella pneumoniae 23 isolates (16.20%), Pseudomanas aeruginosa 18 isolates (12.68%), Acinetobacter baumanni 9 isolates (6.34%), Enterobacter cloacae 5 isolates (3.52%), Citrobacter koseri 1 isolate (0.70%) and Proteus Mirabilis 1 isolate (0.70%). out of 142 total positive isolates in which gram positive isolate frequency 30.99% and gram negative isolates frequency 69.01%.Singh A et al (2019) 20 found in their study that Staphylococcus SPP 66 isolates (36.1%) were predominant bacteria isolates followed by E coli 44 isolates (24.0%) and then Klebsiella pneumoniae 26 isolates (14.2%). Sahar Mudassar et al (2018) 21 found that Staphylococcus spp 46(4.2%) was the commonest followed by Pseudomonas aeruginosa (19%).…”