Bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection at a tertiary teaching hospital in Ethiopia: a prospective cohort study

Abstract

Background Globally, surgical site infections are the most reported healthcare-associated infection and common surgical complication. In developing countries such as Ethiopia, there is a paucity of published reports on the microbiologic profile and resistance patterns of an isolates. Objective This study aimed at assessing the bacterial profile and antimicrobial susceptibility patterns of isolates among patients diagnosed with surgical site infection at Jimma Medical Center in Ethiopia. Methods A prospective cohort study was employed among adult patients who underwent either elective or emergency surgical procedures. All the eligible patients were followed for 30 days for the occurrence of surgical site infection (SSI). From those who developed SSI, infected wound specimens were collected and studied bacteriologically. Results Of 251 study participants, 126 (50.2%) of them were females. The mean ± SD age of the patients was 38 ± 16.30 years. The overall postoperative surgical site infection rate was 21.1% and of these 71.7% (38/53) were culture positive. On gram stain analysis, 78% of them were Gram-negative, 11.5% were Gram-positive and 10.5% were a mixture of two microbial growths. Escherichia coli accounted for (21.43%), followed by Pseudomonas aeruginosa (19.05%), Proteus species (spp.) 14.29%), Staphylococcus aureus (11.90%), Klebsiella species (11.90%), Citrobacter spp. (9.5%), streptococcal spp. (7.14%), Coagulase-negative S. aureus (CoNS) (2.38%) Conclusion Gram-negative bacteria were the most dominant isolates from surgical sites in the study area. Among the Gram-negative bacilli, Escherichia coli were the most common bacteria causing surgical site infection. As there is high antibiotic resistance observed in the current study, it is necessary for routine microbial analysis of samples and their antibiogram.

Assessment of Bacterial Profiles and Antimicrobial Susceptibility Pattern of Isolates Among Patients Diagnosed with Surgical Site Infections at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia: A Prospective Observational Cohort Study

“…From Gram-positive bacteria, Staphylococcus aureus is the predominant (19.5%) isolate, followed by CoNS (7.3%). The predominance of the above isolates is inconsistent with study findings in other parts of Ethiopia, 29 , 30 , 38 , 39 as well as in other developing countries. 26 , 40 The advantages of the above isolates have also been reported in several European countries.…”

“… 6 , 28 However, this finding is lower than the study finding in other parts of Ethiopia, in which the average rates of SSIs was 21.5%. 16 , 29–32 Compared with developed countries, this finding is higher than those of several European countries and the USA, in which the cumulative incidence of SSIs ranges from 0.8–9.5% in Europe 33 and is 0.9% in the USA. 34…”

“…High resistance rates toward the above antibiotics were also reported in other studies. 26 , 29 , 30 , 38 , 39 A study in Tanzania also showed that the majority (97%) of the Gram-negative bacteria were resistant to more than four classes of antibiotics. 40 This can pose a huge challenge for the prevention of SSIs, especially in our case where ampicillin and ceftriaxone are the most commonly used antibiotics in all patients undergoing surgery.…”

“…The present findings seem to be consistent with other research findings which highlighted some SSI risk factors, such as age, ASA class, wound classification, skill and experience of the surgeon, duration of surgery, blood transfusion, and emergency surgery. 16 , 19 , 26 , 29 , 31 Therefore, the prevention of these infections is complex and requires a comprehensive set of preventive measures before, during, and after surgery.…”

“…The presence of highly resistant bacteria causing SSIs has also been reported in other studies. 26 , 29 , 30 , 38–40 This significantly higher resistance may be related to the frequent and inappropriate use of these antibiotics for therapeutic and prophylactic purposes in human infections. The studies have demonstrated almost linear relationships between antibiotic consumption and the prevalence of antimicrobial resistance (AMR).…”