Bacterial Pathogens Isolated from Surgical Wound and Their Antimicrobial Resistance Pattern in A Government Hospital in Anambra, Nigeria

Bacterial Pathogens Isolated from Surgical Wound and Their Antimicrobial Resistance Pattern in A Government Hospital in Anambra, Nigeria

F.O. Nwajiobi*, C.O. Anyamene and C.U. Ezebialu
Department of Applied Microbiology and Brewing, Faculty of Biosciences, Nnamdi Azikiwe University, Awka, Nigeria
DOI: https://doi.org/10.51584/IJRIAS.2023.8626
Received: 04 June 2023; Revised: 19 June 2023; Accepted: 23 June 2023; Published: 24 July 2023

Abstract: – Surgical wound infections are among the most common healthcare-associated infections as complications associated with them can have a significant long-term effect on the morbidity, mortality, and quality of life for patients. Knowledge on local pathogens and sensitivity to antimicrobial agents are crucial for successful treatment and management of surgical wound infection. This study evaluates the bacterial pathogens present in infected surgical wounds and their antimicrobial susceptibility profile. A total of 200 wound swabs from 112 males and 88 female patients of ages from 10 – 70 years with surgical wound infection were collected using clean, sterile swabs and analyzed using standard microbiological methods. Antibiotic disk diffusion method was used to determine the antibiotic resistance profile. Result showed that 142(71%) wound specimens were culture positive while 58(29%) showed no growth on culture media. Majority of the culture positive wounds (90.1%) showed single bacterial growth while the remaining (9.9%) revealed poly-microbial growth. The isolates were found to belong to both Gram-positive 53(37.3%) and Gram-negative 89(62.7%) bacteria. The most predominant isolate from the infected surgical wound was Gram-positive Staphylococcus aureus 53 (37.3%), followed by Gram-negative Pseudomonas aeruginosa 45(31.7%), Escherichia coli 32 (22.5%) and Klebsiella pneumoniae 12 (8.5%). The result of their antibiotic sensitivity test showed that majority of the wound isolates were highly resistant to ampicillin 126(88.7 %), followed by erythromycin 114(80.3%), gentamicin 109(76.7%) and trimetoprim-sulphametoxazole 103(72.5%). The overall findings on antimicrobial profile revealed high level of antimicrobial resistance from microorganisms isolated from surgical wound infections to commonly prescribed antibiotics. Therefore, there is a need for adequate intervention to control the spread of antimicrobial resistance.

Keywords: surgical wound infection, antimicrobial resistance, wound pathogenic bacteria, surgical wound

I. Introduction

Wound is a complex micro- environment where infections by bacterial pathogens represent major concerns in patient treatment. There are various types of wounds, including an incised wound, lacerated wound, surgical wound, ulcer and burn wound [1]. Surgical wounds are the most common wounds seen in hospitals and inappropriate management of the wound may delay wound healing making the wound prone to infection [2]. Surgical wound infections also known as surgical site infections are defined as infection occurring along the surgical wound within 30 days after surgery or within one year if an implant is used and left in place [3]. Surgical wound infections occur as a result of the presence of replicating microorganisms at or within a surgical incision [4]. Surgical wound infection continues to be a challenging healthcare problem. It increases overall hospital costs, the length of hospital stay and may have a significant effect on the morbidity and mortality for patients [5].
The causative agents of surgical wound infections may vary from hospital to hospital and from geographical location. Surgical wound contamination may occur at the time of surgery or at any time thereafter until healing is complete. The sources of bacteria in surgical wound can originate either from patient’s own normal flora or from hospital environment [6]. Surgical wound can be infected with different groups of microorganisms including bacteria, fungi and viruses. The common surgical wound pathogens includes; Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Proteus species, Streptococcus species, Klebsiella species, Acinetobacter species and Enterobacter species [7]. Many studies around the world have been conducted to identify the bacterial species isolated from surgical wound infections. A study carried out in Bangladesh, showed that the most common bacterial species isolated from different types of wounds including surgical wounds were Staphylococcus aureus (36.9%), followed by Escherichia coli (35.8%) Pseudomonas spp. (17.3%) and Proteus spp. (5.8%) [8].