PREVALENCE AND PHENOTYPIC CHARACTERIZATION OF MULTI-DRUG-RESISTANT ISOLATES CAUSING WOUND INFECTIONS IN A TERTIARY CARE CENTRE

Abstract

Objective: Wound infections lead to 70-80% mortality among post-surgeries and one-third of nosocomial infections. The prolonged hospitalization due to diagnostic tests, complete antibiotic course, and clearing of wound infection all together increase the healthcare cost.Methods: The present study was a cross-sectional study carried out in the Department of Microbiology, Central laboratory, and teaching hospital from May 2022 to October 2022. All consecutive, non-duplicate gram-positive and gram-negative bacteria isolates were collected from pus and wound swabs from outpatients and hospitalized patients during the study period.Results: A total of 260 isolates from various wound swabs and pus samples were collected from March 2022 to August 2022. Species-wise distribution of organisms along with antibiotic susceptibility testing shows that 15 out of 63 (24%) Escherichia coli, 12 out of 38 (31.5%) Klebsiella pneumoniae, 06 out of 29 (20.6%) P. aeruginosa, 06 out of 09 (40%) Acinetobacter baumannii, 05 out of 08 (62%) Klebsiella oxytoca, 04 out of 12 (33%) Citrobacter freundii, 01 out of 07 (14.3%) Enterobacter aerogenes were multi-drug-resistant (MDR). Previously few studies mentioned S. aureus was predominant, followed by P. aeruginosa in polymicrobial wound infections. Our study found that around 2-3% of cultures showed two organisms. The antibiotics like amikacin and imipenem worked well against all gram-negative organisms up to 72%, and 85%, respectively. Similar findings of organisms in other studies showed sensitivity to amikacin and imipenem up to 77% and 100%; 70% and 83%, respectively.Conclusion: The organisms causing wound infections and the empirical therapy and switch to correct antibiotics as soon as possible to avoid misuse of antimicrobials and prevent the spread of drug-resistant strains among the community and hospital setup.