Bacteriological profile and antibiotics susceptibility patterns of complicated skin and skin structure infections in tertiary care hospitals, Peshawar (original) (raw)
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Background: Purulent skin infections due to Staphylococcus aureus are common in hospitals and are frequently due to secondary bacterial infections. The aims of this study were to evaluate antibiotic resistance and to describe the factors associated with Staphylococcus aureus purulent skin infections. Methods: This is a descriptive and cross-sectional study of 179 results of cytobacteriological examinations of pus over a period of 18 months, from January 2021 to June 2022, at the laboratory of the University Hospital of Befelatanana. Results: Among the 179 cytobacteriological examinations of pus, 131 cases were positive showing a hospital prevalence of 73.2%. Among the germs identified, 46 cases (25.7%) were represented by isolates of Staphylococcus aureus. Regarding the associated factors, subjects aged 60 and over (30%) (p=0.32; NS), women (32.8%) (p=0.11; NS) and patients hospitalized in Internal Medicine departments (39.3%)(p=0 .02) were the most affected by Staphylococcus aureus purulent skin infections. Concerning the results of the antibiograms, the resistances of the isolates of Staphylococcus aureus to Penicillin G (97.8%), to Doxycycline (56.5%) and to Cotrimoxazole (41.3%) were the highest. Methicillin-resistant Staphylococcus aureus isolates were rare (4.3%) and all isolates were susceptible to Vancomycin. Conclusion: The prevention of cutaneous suppuration in vulnerable people is very important in hospital departments as well as hospital hygiene measures to fight against nosocomial infections. Similarly, it is necessary to limit the use of broad-spectrum antibiotics in hospital departments to control the evolution of Staphylococus aureus isolates towards increasing antibiotic resistance.
Journal of Lumbini Medical College, 2020
Introduction: Wound infection due to various pathogenic microorganisms and the development of resistance to antibiotics is one of the major problems in medical sector. This study aimed to identify the etiological agents of wound infection along with their antibiotic susceptibility. Methods: A total of 400 wound swab specimens were collected from the patients visiting a tertiary center in western Nepal over a period of six months. Thus, collected specimens were processed in Microbiology laboratory for isolation of causative agents. Antibiotic susceptibility test was performed for entire isolates by Kirby Baur disc diffusion method. Methicillin-Resistant Staphylococcus aureus was detected by cefoxitin disc diffusion test and Extended- Spectrum Beta-Lactamases producing Enterobacteriaeae by Phenotypic confirmatory disc diffusion test as recommended by Clinical and Laboratory Standards Institute. Results: Two hundred and fifty-nine (64.7%) of specimens were infected, giving rise to 269 ...
2018
Wound infection can be caused by variety of organisms like bacteria, virus, fungi and protozoa and may co-exist as poly microbial communities. Even though the bacterial profile of pus samples in many studies remain the same, the antibiotic resistance pattern of these isolates has shown a lot of variations. This study was conducted in the department of microbiology of a private tertiary care hospital CCM Medical College Durg, Chhattisgarh over a period of one year from January 2017 to December 2017. Antibiotic sensitivity testing of Staphylococcal isolates was performed by modified Kirby Bauer’s disc diffusion method. Total of 387 samples were processed for aerobic culture and sensitivity, of which in 304 (78.55%) samples single growth was observed. Of the total 304 isolates, 274 isolates were from surgical units and 30 isolates from medicine units. Isolation of Gram positive and Gram negative organisms was 144 (47.36%) and 158 (51.97%) respectively and 2 (0.65%) species were candida...
IP Innovative Publication Pvt. Ltd., 2017
Objectives: To study the prevalence and resistance pattern of Staphylococcus aureus isolated from abscesses from a tertiary care centre. Materials and Method: A retrospective study was done at Department of Microbiology, Aarupadai Veedu Medical College and Hospital on 465 isolates from pus samples of which 218 isolates were identified as Staphylococcus aureus upon standard techniques. The samples were obtained from patients with abscess from various sites like foot, legs, hands, surgical sites, skin ulcers, injection wounds of both inpatients and outpatients of all age groups and both gender. Results: Overall rate of culture positive abscesses were 35.6% (n=465/1306). Staphylococcus aureus is the predominant pathogen isolated contributing to 46.88% (n=218/465) isolates followed by Pseudomonas aeruginosa 15.4% (n=72/465), Escherichia coli 11.1% (n=52/465), Klebsiella spp 6.5% (n=30/465), Proteus spp 5.3% (n=25/465), Enterococcus spp 4.3% (n=20/465), Streptococcus spp2.7% (n=13/465). The highest resistance were observed for Penicillin 98% (n=214/218), followed by Methicillin 79.3% (n=173/218), Clindamycin 73.6% (n=160/218), Streptomycin 72.6% (n=158/218), Amoxyclav 65% (n=142/218), Chloramphenicol 41.8% (n=91/218). Majority of Staphylococcus aureus isolates were sensitive to Vancomycin 97% (n=211/218), Gentamicin 95% (n=207/218), Ciprofloxacin 85% (n=185/218), Erythromycin 78.1% (n=170/218), Oxacilin 52% (n=113/218), Ampicilin 61.3% (n=134/218). Conclusion: Staphylococcus aureus is the predominant pathogen isolated in our study. Higher rate of isolation were seen among skin ulcers as they are more exposed to environment. Following them were from diabetes patients, since Staphylococcus aureus play vital role in causing varied ulcers because of their lower immunity status. Resistance rates were high for Penicillin, Methicillin, Amoxyclav, Clindamycin and Chloramphenicol because of the abundant use in routine practice. Judicial use of antibiotics, better hygiene and good clinical practices should be followed to prevent the severity of these infections.
International Journal of Researches in Biosciences and Agriculture Technology
Antibiotic resistant pathogens constitute an important and growing threat to the public health. Antibiotic resistance occurs when a microbe acquires a gene, which allows the microbe to inactivate the antibiotic or otherwise nullify its antimicrobial activity. Staphylococci are widespread pathogens and are frequently associated with hospital-acquired infections. Healthcare-associated methicillin-resistant S. aureus (MRSA) is a major cause of nosocomial infections worldwide, with significant attributable morbidity and mortality in addition to pronounced healthcare costs. Many hospitals struggle with increasing amounts of MRSA, which are "multi-resistant" against all beta-lactam antibiotics. Often, applicable antibiotics for treatment are only glycopeptides like vancomycin. The main objectives of this study was to find out the antimicrobial susceptibility pattern of S.aureus isolates, the prevalence of methicillin resistant S.aureus and demonstration of Vancomycin resistance among MRSA strains Method: A total 139 clinical samples like pus, sputum and burn wounds are screened for the isolation of S.aureus strains. The pure isolates of coagulase positive S.aureus were tested for antimicrobial susceptibility by using standard methods. Results: Out of 139 clinical specimens 100 samples were found to be coagulase negative S.aureus. High resistance was observed against , penicillin, erythromycin and tetracycline. High sensitivity was recorded against amikasin, chloramphenicol & Gentamycin. Of the isolates 76 isolates were methicillin resistant S.aureus (MRSA). Vancomycin resistant among MRSA isolates was found 14%. Conclusion: Our study emphasizes the need for continuous monitoring of the antimicrobial susceptibility pattern of S.aureus isolates including MRSA for the selection of appropriate therapy. In Chandrapur , from the present findings it appears that the spread of MRSA in community is very high and the vancomycin which is the last choice for the treatment MRSA strains also shown resistant. So there is need of high alert in hospital settings and need of continuous monitoring and surveillance to control resistance.
Annals of Clinical Microbiology and Antimicrobials
Background: The increasing drug resistance along with inducible clindamycin resistance, methicillin resistance and biofilm production among the strains of Staphylococcus aureus are present as the serious problems to the successful treatment of the infections caused by S. aureus. So, the main objectives of this study were to determine the antimicrobial susceptibility patterns along with the rates of inducible clindamycin resistance, methicillin resistance and biofilm production among the strains of S. aureus isolated from pus/wound swab samples. Methods: A total of 830 non-repeated pus/wound swab samples were processed using standard microbiological techniques. The colonies grown were identified on the basis of colony morphology, Gram's stain and biochemical tests. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion technique. Detection of inducible clindamycin resistance was performed by D test, while detection of methicillin resistant S. aureus (MRSA) was performed by determination of minimum inhibitory concentration of oxacillin by agar dilution method. Similarly, detection of biofilm formation was performed by microtiter plate method. Strains showing resistance to three or more than three different classes of antibiotics were considered multidrug resistant. Results: Total 76 samples showed the growth of S. aureus, among which 36 (47.4%) contained MRSA and 17 (22.4%) samples were found to have S. aureus showing inducible clindamycin resistance. Among the S. aureus isolated from outpatients, 41.9% were MRSA. Highest rates of susceptibility of S. aureus were seen toward linezolid (100%) and vancomycin (100%). Similarly, S. aureus isolated from 35 (46.1%) samples were found to be biofilm producers. Higher rate of inducible clindamycin resistance was seen among MRSA in comparison to methicillin susceptible S. aureus (MSSA). Similarly, higher rates of multidrug resistance and methicillin resistance were found among biofilm producing strains in comparison to biofilm non producing strains. Conclusions: The rate of isolation of MRSA from community acquired infections was found to be high in Nepal. Increased rate of inducible clindamycin resistance as compared to previous studies in Nepal was noted. So for the proper management of the infections caused by S. aureus, D test for the detection of inducible clindamycin resistance should be included in the routine laboratory diagnosis. Further, detection of biofilm production should also be included in the routine tests. Linezolid and vancomycin can be used for the preliminary treatment of the serious infections caused by S. aureus.
BMC research notes, 2014
Background: In spite of advances in control of infections, wound infections have not completely controlled due to many reasons. The widespread uses of antibiotics, together with the length of time over which they have been available have led to major problems of resistant organisms contributing to morbidity and mortality. This study was aimed to assess bacterial isolates and their drug susceptibility patterns from patients with pus and/or wound discharge. . Socio-demographic and laboratory results were collected from the University Hospital Microbiology Laboratory unit registration books by using a standard data collection format. Data were analyzed using SPSS version 20 software. P-value ≤ 0.05 was considered statistically significant. Result: A total of 628 study subjects were included in the study with bacterial isolation rate of 441 (70.2%). Of all, 344 (54.8%) were males. Two hundred eighty two (63.9%) of the isolates were gram positive and 159 (36.1%) were gram negative. About 331/ 441 (75.0%) of the total isolates were Staphylococcus aureus (32.9%), Coagulase Negative staphylococci (14.7%), Streptococcus spp. (11.6%), Escherichia coli (9.5%), Klebsiella spp. (6.3%). The result showed that 66.2% of the isolates were resistant to tetracycline, followed 59.8% for ampicillin, 59.1% for cotrimoxazole, 51.7% for penicillin; least resistant being 6.3% for gentamycin. Conclusion: High prevalence of bacterial isolates were found; S. aureus being the dominant. Most of the isolates were resistant to many of the antibiotics tested where all isolates of Pseudomonas spp. being resistant to two or more antibiotics. Antibiotic susceptibility test is necessary for effective control of wound infections.
A wound is any physical injury involving a break in the skin, and exposed subcutaneous tissues provide a favorable substratum for a wide variety of microorganisms to contaminate and colonize. In this study a total of 870 plus samples were collected from patients visiting B & B hospital suspecting wound infection and then analyzed. The causative agents were isolated, identified by culture and biochemical tests and their susceptibility pattern to antibiotics were determined by using CLSI guidelines. Out of total samples, 476(44.8%) showed bacterial growth. Among growth cases 22.9% were mixed growths. Among all bacterial isolates, 12 species were identified of them, 70.6% were Gram-negative and 29.4% were Gram-positive. Among Gram-positive isolates, Staphylococcus. aureus (74.2%) was most common followed by CoNS (8.6%), Non haemolytic Streptococci (8.6%), Enterococcus spp. (4.3%) and β-haemolytic Streptococci (4.3%). Among Gram-negative bacteria, the most common isolate was Pseudomonas aeruginosa (31.5%) followed by E.coli (24.8%), Acinetobacter spp. (14.6%), Enterobacter spp. (14.0%) and Klebsiella spp. (13.4%). Proteus spp. and Citrobacter spp. were less common.With regard to AST pattern, S. aureus was most susceptible to chloramphenicol and highly resistance to penicillin. Among them, 7.7% were MRSA. For other Gram-positive isolates as well, effective drug was found to be chloramphenicol. For P. aeruginosa, the most effective drug was imipenem (94.3%) followed by amikacin (63.2%). Likewise, for other Gram-negative bacteria most effective drug was imipenem followedby amikacin. Among the total P. aeruginosa isolates, 58.5% were found to be MDR. For all these P. aeruginosa isolates MIC on gentamycin and ciprofloxacin illustrate the simultaneous presence of ciprofloxacin resistance and reduced gentamycin susceptibility. These results indicated that antibiotic resistance in Gram-positive and Gram-negative bacteria were increasing in alarming trend that leads to the failure of treatment.
Antibiotic sensitivity patterns of staphylococcal skin infections
Objectives To determine the current sensitivity pattern against staphylococci found in skin and soft tissue infections. Methods Patients were enrolled from OPD of Dermatology Department, PNS Shifa Hospital, Karachi. All the patients with skin infections showing growth of Staphylococcus aureus on culture medium were selected. After informed consent, swab specimens were collected under aseptic measures from skin lesions for microbial analysis and sensitivity pattern. Results Among skin infections, furunculosis was found most common, comprising of 45.7% (n=43), cellulitis 15.0% (n=14), ecthyma 8.5% (n=8), erysipelas 8.5 % (n=8) and impetigo 22.3% (n=21). According to drug sensitivity patterns, vancomycin was found sensitive in 100%, linezolid 98.9%, mupirocin 96.8%, rifampicin 95.7%, chloramphenicol 94.7%, clindamycin 86.2%, amikacin 84%, moxifloxacin 83%, fusidic acid 79.8%, gentamicin 76.6%, oxacillin 69.1%, ciprofloxacin 68.1%, amoxicillin-clavulanic acid 62.8%, erythromycin 60.6% a...
Journal of Vocational Health Studies (JVHS) , 2023
Background: Pyogenic infections that occur can be caused by direct bacterial contamination of the wound, such as infection in a post-surgical wound or infection after trauma. Efforts to control infection can be done with the use of antibiotics. Purpose: To determine the profile of bacteria and antibiotic sensitivity in wound culture in hospitalized patients in Hajj General Hospital Surabaya, East Java in 2021. Method: This study used the Chi-square test and descriptive analysis in the form of distribution tables and percentages using secondary data based on the results of examination of pus culture at the Clinical Microbiology Laboratory in Hajj General Hospital Surabaya, East Java in 2021. Result: The results of research on wound culture samples showed as many as 113 patients (56.22%) with positive culture results, which were predominantly female as many as 59 patients (50.9%) and the highest age category namely at the age of 46-55 years as many as 39 patients (33.6%). Based on bacteria, the most dominant type of bacteria in the Gram-negative group was Escherichia coli ESBL with 21 isolates (26.6%), while Gram-positive bacteria, Staphylococcus aureus, was found in 16 isolates (43.3). The results of antibiotic sensitivity on Gram-negative bacteria were Piperacillin/Tazobactam and Meropenem, and on Gram-positive bacteria Vancomycin and Linezolid were obtained. Conclusion: E. coli and S. aureus are the most important causes of wound infections and the suppressor organisms in this study. Antibiotic susceptibility testing of all isolates showed that the antibiotics amikacin and meropenem were sensitive to Gram-negative bacteria especially ESBL-producing bacteria, and the antibiotics vancomycin and linezolid were sensitive to Gram-positive bacteria especially MRSA