Abstract
BACKGROUND Emergence of multidrug-resistant bacterial pathogens in hospitals and associated risk factors are a strenuous task for clinicians to treat surgical site infections (SSIs). Isolation of multidrug-resistant organisms is an existing problem with a rising trend in Indian hospitals. We wanted to study the microbial profile, their susceptibility pattern, risk factors of SSIs, and revise the antibiotic prophylaxis policy to reduce injudicious use of antimicrobial agents. METHODS The present prospective observational study included 1073 post-operative patients of different surgeries held at a Tertiary Care Hospital in western India from July 2017 to August 2018. Samples were collected using a sterile cotton swab stick and processed as per standard operative procedures in appropriate culture media and susceptibility testing was done using the Kirby-Bauer disc diffusion technique. After incubation plates were examined under the reflected light they were interpreted according to clinical and laboratory standards institute (CLSI) guidelines. RESULTS Among 1073 samples, bacteriologically proven surgical site infection was identified in 63 (5.87 %) patients. In the present study, the predominant organism isolated was E. coli (28.57 %), followed by Klebsiella spp. (23.81 %), Staphylococcus aureus (19.05 %), Pseudomonas aeruginosa (17.46 %), Acinetobacter spp. (9.52 %), and Proteus mirabilis (1.59 %). Pan-antibiotic resistance was noted among 14 (27.45 %) gram-negative rods and 7 (58.33 %) methicillin-resistant Staphylococcus aureus strains were isolated. CONCLUSIONS Overall, resistance to the cephalosporin group of antibiotics and penicillin group has increased. So, rather than moving on to the higher generation antibiotics, aminoglycosides (amikacin/gentamycin) and fluoroquinolones (levofloxacin) are the better-preferred drugs. KEYWORDS Surgical Site Infections, Injudicious Use of Antimicrobial Agents, Antibiotic Prophylaxis Policy
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