Bacterial Isolates and Their Antimicrobial Susceptibility Patterns of Wound Infections among Inpatients and Outpatients Attending the University of Gondar Referral Hospital, Northwest Ethiopia

Abstract

Background. The widespread uses of antibiotics, together with the length of time over which they have been available, have led to the emergence of resistant bacterial pathogens contributing to morbidity and mortality. This study was aimed to assess bacterial isolates and their drug susceptibility patterns from inpatients and outpatients with pus and/or wound discharge. Methods. A cross-sectional study was conducted at the University of Gondar Referral Hospital from March to May, 2014. Wound swab samples were collected from each study participant and inoculated into appropriate media. The bacterial pathogens were identified using standard microbiological methods. Antimicrobial susceptibility tests were performed using disk diffusion technique following Kirby-Bauer method. Results. A total of 137 study subjects were included in the study with bacterial isolation rate of 115 (83.9%). Of all, 81 (59.1%) were males. Seventy-seven (57%) of the isolates were Gram-negative and 59 (43%) were Gram-positive. From the total isolates, Staphylococcus aureus was the most predominant isolate 39/115 (34%) followed by Klebsiella species (13%), coagulase negative staphylococci spp. (12%) and Pseudomonas aeruginosa. Gram-positive isolates were resistant to ampicillin (86.4%), amoxicillin (83%), penicillin (81.3%), oxacillin (74.6%), and tetracycline (59.4%), while Gram-negative isolates were resistant to amoxicillin (97.4%), ampicillin (94.8%), tetracycline (72.7%), trimethoprim/sulfamethoxazole (66%), and chloramphenicol (54.5%). Conclusion. High prevalence of bacterial isolates was found, Staphylococcus aureus being the most dominant. High rates of multiple drug resistance pathogens to the commonly used antimicrobial agents were isolated. Therefore, concerned bodies should properly monitor the choice of antibiotics to be used as prophylaxis and empiric treatment in the study area.

Determination of Bacterial Profile and Spectrum of Antimicrobial Drug Resistance in Pediatric Wound Infections

“…The higher incidence of S. aureus (54.1%), K. pneumoniae (20.8%) and E. coli (8.3%) are reported in an Indian study 23 . An Ethiopian study reported 28.7% S. aureus, 12.5% Klebsiella, 11.8% coagulasenegative Staphylococci, 11% Citrobacter, 9.6% Enterobacter, 5.9% each of the P. aeruginosa and E. coli and 4.4% Proteus which is contrary to the finding of the present study 20 . The results of a Nigerian study also reported predominantly S. aureus (38%) in wound infections followed by P. aeruginosa (18.7%), Klebsiella (17%), which differ in frequencies reported in the current study 24 .…”

“…Most of the wounds are colonized with a single microbial growth, but some cases of wound infection may have polymicrobial growth. A polymicrobial etiology was observed in cases of pediatric wound infections in this study, which is closer to the polymicrobial growth reported by an Ethiopian study 20 .…”

“…A Pakistani study conducted in a hospital of Peshawar reported 59% of wound infections in males and 41% in females 19 . Another study reported similar findings of a higher incidence of wound infections in male (59.1%) patients than female (40.9%) patients 20 . The culture-negativity was significantly associated with children < 1 year of age in the current study, which is quite the opposite of the findings of a tertiary care hospital in Nepal, which reported a higher rate of wound infections in children under the age of 1 year 12 .…”

“…A higher rate of S. aureus resistance in wound infections have been observed against amoxicillin (82%), ofloxacin (80%), sparfloxacin (78%), ciprofloxacin (71%), levofloxacin (46%) and gentamicin (36%). A single case of VRE was observed, while none of the S. aureus or S. pyogenes found to be resistant to penicillin 20 . A variable number of VRE have been reported in other studies 28,29 .…”

“…Multi-drug resistance has been reported against the eighteen different antibiotics in E. coli and P. aeruginosa. The pathogens showed expanded resistance to cephalosporins, fluoroquinolones, aminoglycosides, and monobactams in wound infections 20 . E. coli strains have been found resistant to co-trimoxazole (63%), ampicillin, and tetracycline (87% each) in a different study 26 .…”