Abstract
Several bacterial species cause post-operative infections, which has been a critical health concern among hospital patients. Our study in this direction is a much-needed exploratory study that was carried out at the National Heart Institute (IJN) of Malaysia to examine the virulence properties of causative bacteria obtained from postoperative patients. The bacterial isolates and data were provided by the IJN. Antibiotic resistance gene patterns, and the ability to form biofilm were investigated for 127 isolates. Klebsiella pneumoniae (36.2%) was the most common isolate collected, which was followed by Pseudomonas aeruginosa (26%), Staphylococcus aureus (23.6%), Streptococcus spp. (8.7%) and Acinetobacter baumannii (5.5%). There were 49 isolates that showed the presence of multidrug resistance genes. The mecA gene was surprisingly found in methicillin-susceptible S. aureus (MSSA), which also carried the ermA gene from those erythromycin-susceptible strains. The phenotypic antibiotic resistance profiles varied greatly between isolates. Findings from the biofilm assay revealed that 44 of the 127 isolates demonstrated the ability to produce biofilms. Our findings provide insights into the possibility of some of these bacteria surviving under antibiotic stress, and some antibiotic resistance genes being silenced.
Highlights
Post-operative infections constitute a major problem among post-surgical patients, and they are one of the most frequently reported healthcare-associated infections all over the world
Few isolates contained Gram-positive bacteria such as Streptococcus species, which were frequently identified as S. dysgalactiae subspecies equisimillis (SDSE) and S. agalactiae
Unlike previous reports [55,56,57], which stated that the majority of postoperative infections are caused by S. aureus, our study showed that most of the cardiac surgery patients were prone to severe postoperative infections caused by K. pneumoniae
Summary
Post-operative infections constitute a major problem among post-surgical patients, and they are one of the most frequently reported healthcare-associated infections all over the world. Most of the infections are usually caused by endogenous infections, which are derived from microorganisms that are already present in the patient’s body [2,3]. It is well-known that distinct microbiota compositions are observed in different skin sites in humans [4,5]. The causative agents may originate from exogenous factors such as unclean operating rooms and infected surgical instruments [3]. The isolated causative agents (either endogenous or exogenous microorganisms) were mostly reported with bacteria, such as Staphylococcus aureus, Klebsiella pneumoniae, coagulase-negative staphylococci and Enterococcus species [6,7,8]
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