Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal

N, Upreti; Rayamajhee, Binod; Sherchan, Samendra P.; Choudhari, Mahesh Kumar; Banjara, Megha Raj

doi:10.1186/s13756-018-0408-z

Cited by 75 publications

(52 citation statements)

References 23 publications

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“…The high rate of bacterial resistance to ceftriaxone is likely due to frequent use of this antibiotic in and outside hospitals. Our nding that almost all P. aeruginosa and A. baumannii were sensitive to amikacin and had relatively moderate resistance to cefepime (15.5%), ceftazidime (20.7%), and cipro oxacin (20.7%) are similar to those in studies in Nepal and India [31,32], which observed moderate resistance to cipro oxacin (6.2% to 24%). High sensitivity to imipenem and amikacin may be due to the limited exposure of these drugs to the prescription antibiotics that are relatively more expensive and not constently available in Benin.…”

Section: Discussionsupporting

confidence: 83%

Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

Yehouenou

Kpangon

Affolabi

et al. 2020

Preprint

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Background: Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in these infections and the rate of multidrug-resistant bacteria in six public hospitals in Benin. Methods: Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. For the antibiotic susceptibility test, we first used the Kirby-Bauer disk diffusion method. The secondary test (by microdilution) used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results: We included 304 patients, whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics, S. aureus (28.5%, n=42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery, the most dominant being E. coli (38.4%, n=31). Overall, 90.8% (n=208) of aerobic bacteria were multidrug resistant. Two-thirds of S. aureus (65.3%, n= 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n=43/62) and 83.3% of K. pneumoniae (n=25/30). Overall, twelve Gram-negative bacteria (5.24%) showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype. Conclusion: This study shows the alarming prevalence of multidrug-resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of such bacteria, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.

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Section: Discussionsupporting

confidence: 83%

Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

Yehouenou

Kpangon

Affolabi

et al. 2020

Preprint

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“…The high rate of bacterial resistance against ceftriaxone is likely due to frequent use of this antibiotic in and outside hospitals. Our nding that almost all P. aeruginosa and A. baumannii were sensitive to amikacin and had relatively moderate resistance to cefepime (15.5%), ceftazidime (20.7%), and cipro oxacin (20.7%) are similar to those in studies in Nepal and India [28,29], which observed moderate resistance to cipro oxacin (6.2% to 24%). High sensitivity to imipenem and amikacin may be due to the limited exposure of these drugs to the prescription antibiotics that are relatively more expensive and are not constently available in Benin.…”

Section: Discussionsupporting

confidence: 83%

“…Some two thirds of our isolates (65.3%) were resistant to cefoxitin and were reported as MRSA species. Upreti and Shrestha in Nepal found the same rate of MRSA [28,29]. In a retrospective single center study conducted in 2016 by Mercy Ship during surgical outreaches in six sub-Saharan African countries (Benin,Togo, Liberia, Madagascar, Congo and Sierra-leone) Lai PS et al found the highest rates of MRSA in Benin (34.6%) and Congo (31.9%) and the lowest rate in Togo (14.3%) and Madagascar (14.5%) [30].…”

Section: Discussionmentioning

confidence: 73%

Antimicrobial Resistance in Hospitalized Surgical Patients: a Silently Emerging Public Health Concern in Benin.

Yehouenou¹,

Kpangon

Affolabi³

et al. 2020

Preprint

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Background: Surgical site infections are related to high morbidity, mortality and healthcare costs. As the emergence of multidrug-resistant bacterial pathogens in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in surgical site infections and their susceptibility pattern in six public hospitals in Benin. Methods: Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. The antibiotic susceptibility test firstly used the Kirby-Bauer disc diffusion method. The secondary test by microdilution used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results: We included 304 patients (mean age 32 ± 11 years), whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics S. aureus (28.5%, n=42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery. The most dominant being E.coli (38.4%, n=31). Overall, 90.8% (n=208) of aerobic bacteria were multidrug resistant. Two-third of S. aureus (65.3%, n= 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lactamases were presented by 69.4% of E.coli (n=43/62) and 83.3% of K. pneumoniae (n=25/30). Overall, twelve Gram negative bacteria (5.24%) isolates showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype.Conclusion: This study shows the alarming prevalence of multidrug resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of these multidrug-resistant bacteria, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential.

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“…15 Because colistin resistance has already been reported in some parts of the world, it may be expected in this region too though not reported yet. 4,[9][10][11][12]15 Combination of colistin with meropenem is shown ineffective in preventing emergence of resistance to colistin in a study. So judicious use of this valuable antibiotic seems to be the way to preserve sensitivity of the highly resistant organisms.…”

Section: Discussionmentioning

confidence: 98%

Sensitivity Pattern of Gram Negative Bacteria Contaminating Traumatic Wounds: A Retrospective Study in a Tertiary Care Hospital of Kathamandu Valley

Suwal¹,

Kaundinnyayana²,

Prajapati³

et al. 2020

Med. J. Shree Birendra Hosp.

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Introduction: Gram negative bacteria are commonly involved in wound infections and are significantly associated with morbidity and mortality because of increasing resistance to commonly used antibacterial agents. This study aims to evaluate the pattern of antibacterial sensitivity of the gram negative bacteria from wound swabs of accidental trauma cases. Methods: This retrospective study was done by collecting all the culture positive reports for wound swabs of accidental wounds from the microbiology laboratory and analyzing the reports showing growth of gram negative bacteria for frequency of sensitivity to commonly used antibacterial agents. Results: Culture positivity rate was 21.95% with growth of gram negative bacteria in 79.7% of cases. The most commonly isolated organism was Escherichia coli being 41.3% among gram negative isolates. Highly resistant bacteria were E. coli, Klebsiella pneumoniae and Acinetobacter spp. Conclusions: As there is low culture positivity rate for wound swabs obtained before washing the wounds inflicted by accidental trauma, prolonged routine use of prophylactic antibiotic is not justified. Thoroughly washing the wound is very likely to decrease the rate of wound infection further and reduces the need of antibacterial agents. Culture and sensitivity test should guide the treatment when wound is infected because highly resistant gram negative organism may be involved in such cases.

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Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal

Cited by 75 publications

References 23 publications

Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin

Antimicrobial Resistance in Hospitalized Surgical Patients: a Silently Emerging Public Health Concern in Benin.

Sensitivity Pattern of Gram Negative Bacteria Contaminating Traumatic Wounds: A Retrospective Study in a Tertiary Care Hospital of Kathamandu Valley

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