Multidrug resistant Psudomonas aeruginosa infections complicating surgical wounds and the potential challenges in managing post–operative wound infections: University of Calabar Teaching Hospital experience

Abstract

Objective To ascertain the antimicrobial susceptibility profile of Pseudomonas aeruginosa (P. aeruginosa) recovered from surgical site infections (SSIs). Methods The study was retrospective in nature and was compiled for a period of five years (1st February, 2004–31st January, 2009). Data were generated from the culture of post-operative wound swab specimens by the microbiology laboratory of University of Calabar Teaching Hospital. Relevant information from the patients' records was compiled, such as age, gender, type of surgical procedure, microorganisms recovered and their antibiotic sensitivity patterns. Obtained data was analysed by using Epi Info 6 statistical software. Results Of the 4 533 wound swab specimens processed, 673 were culture positive and P. aeruginosa was recovered from 13.1% of the culture positive specimens with its rate of recovery decreasing with age progression (P< 0.05) but with no gender difference (P> 0.05). Most of the P. aeruginosa isolates were from general surgery wards and least from orthopaedic wards. Ofloxacin, ceftriaxone and augmentin were the most active antibiotics while ampicillin, tetracycline and cotrimoxazole were the least active antibiotics, with no antibiotic having a 100% activity against the organism. Conclusions In view of the high resistance displayed by P. aeruginosa recovered from SSIs, adequate antiseptic procedures should be entrenched to avoid colonization of surgical wounds by this microorganism as well as others with similar sensitivity profile. Ofloxacin, ceftriaxone and augmentin may be considered for prevention of P.aeruginosa infection.