To identify bacterial aetiology of surgical site infections and their antibiogram to find drug useful for empirical treatment.

Abstract

Aim: The aim of the present study is to identify bacterial etiology of surgical site infections and their antibiogram to find drug useful for empirical treatment. Material and methods:The study was a crosssectional study which was carried in the Department of General Surgery, PMCH, Bihar, Indiafor 18 months. Using sterile cotton swabs, two pus swabs/ wound swabs were collected aseptically from each patient suspected of having SSI. Gram stained preparations were made from one swab for provisional diagnosis. The other swab was inoculated on nutrient agar, 5% sheep blood agar (BA) and MacConkey agar (MA) plates and incubated at 37°C for 24-48 hours before being reported as sterile. Growth on culture plates was identified by its colony characters and the battery of standard biochemical tests. All the isolates were tested for antimicrobial susceptibility by Kirby Bauer disk diffusion technique on Muller Hinton Agar. Results: Out of 410 samples, 200 samples were culture positive (48.78%). Among 200 positive samples 109 (54.5%) were males. Maximum no. of culture positive samples in age 20-30 years (33.5%) followed by 30-40 (16.5 %) and then followed by 40-50 (14.5%) of age group respectively. Out of 200 culture positive samples S.aureus (26.5%) was the most common pathogen isolated followed by Escherichia coli. (22.5%), Citrobacter spp. (15.5%) and Pseudomonas aeruginosa (9.5%) respectively. Among gram negative bacilli, E.coli was most sensitive to Imipenem 88.89%) followed by Amikacin (77.77%) and Piperacillin Tazobactam (73.33%) whereas for Citrobacter spp., Imipenem (74.19%) followed by Gentamicin  (45.16%), Ciprofloxacin (41.93%) was the drug of choice then for Klebsiella spp., Imipenem (76.47%) followed by Gentamicin (47.05%), Amikacin (47.05%) was the drug of choice. For Pseudomonas aeruginosa, Imipenem (68.42%) followed by Piperacillin Tazobactam (63.16%), Gentamicin (57.89%) was the drug of choice and for Enterobacter spp., Imipenem (76.92%) followed by Amikacin (53.84%), Piperacillin Tazobactam (53.84%) showed maximum sensitivity . Among gram positive organism, S.aureus showed maximum antibiotic sensitivity to Linezolid (96.22%) followed by Vancomycin (94.33%), Amikacin (83.02%) whereas CONS was sensitive to Linezolid (93.33%) followed by Vancomycin (86.67%), and Gentamicin (80%).Conclusion: We conclude that despite of modern surgical techniques and antimicrobial availability and use, SSIs are common among patients undergoing surgeries. Bacterial resistance is a serious threat for treating infections and exists for more commonly available and used antimicrobials.

Key words: bacterial,etiology