Surgical wound sepsis and respective resistance profiles of the bacterial isolates among post operative patients at Case Hospital

Abstract

Bacterial post-surgical wound sepsis is one of the infections that cause burden to a good number of patients in hospitals and antimicrobial resistance has increased drastically in recent years in both developed and developing countries and it has rapidly become a leading public health concern. Therefore, a laboratory based cross-sectional study was conducted at Case Hospital Kampala to determine the prevalence of post-surgical site infections, bacterial profile and the resistance profiles of the bacterial isolates. One hundred fifty-three (153) patients were involved in the study and majority were males accounting for 84/153 (54.9%). Most of the patients were in the age group of 31-45 years of age (26.8%). The mean age of patients was 40.5±21 years. The overall prevalence of surgical wound sepsis (SWS) among patients was 64/153 (41.83%). A total of 66 bacteria were isolated and Staphylococcus aureus constituted the highest percentage 29/66 (43.9%) followed by Escherichia coli which constituted 12/66 (18.18%). Klebsiella pneumoniae accounted for 9/66 (13.64%) and Pseudomonas aeruginosa 8/66 (12.12%). The least isolated bacteria were Enterococcus sp and Streptococcus pyogenes both at 2/66 (3.03%). Most of the bacteria isolated were resistant to Oxacillin and Ampicillin with resistance reaching up to 100%. Pseudomonas aeruginosa was multi-drug resistant and showed the highest resistance to most antibiotics. Escherichia coli was susceptible to Meropenem (100%), Ciprofloxacin (83.3%), Gentamycin (58.3%), Amikacin (83.3%) and Ceftazidime Clavulanic acid (58.3%) but resistant to Ceftriaxone (75%), Ampicillin (100%) and Oxacillin (58.3%). Klebsiella pneumoniae was susceptible to Meropenem (100%), Gentamycin (67.7%), Amikacin (88.9%) and Ceftazidime-Clavulanic acid (66.7%) but resistant to Ampicillin (100%), and Oxacillin (67.7) with minimal resistance to Ceftriaxone (55.6%). Staphylococcus aureus was susceptible to Meropenem (86.2%), Gentamicin (58.6%) and Vancomycin (86.2). Due to high burden of Pus associated infections, there is need for appropriate infection prevention and control measures. Ampicillin is no longer and an appropriate antibiotic for treatment of pus associated infections.