Prevalence and Antimicrobial Susceptibility of Wound Pathogens in a Tertiary Care Hospital in Kashmir: A Cross-sectional Study
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Background Wound infections significantly impact morbidity, mortality, and healthcare costs globally. The Kashmir Valley's unique geographical and climatic conditions, coupled with resource constraints and antibiotic misuse, complicate managing these infections effectively. This study aimed to identify predominant bacterial pathogens in wound infections at a tertiary care hospital in Kashmir, determine their antibiotic susceptibility profiles, and estimate the prevalence of multidrug-resistant (MDR) strains. Materials and Methods A prospective cross-sectional study was conducted from January to June 2023 at the Government Medical College, Srinagar. Pus samples from wound infections were aseptically collected and processed following standard microbiological protocols. Antibiotic susceptibility testing utilized the Kirby-Bauer disk diffusion method, adhering to Clinical and Laboratory Standards Institute guidelines. Data were analyzed using IBM SPSS statistics. Results Out of 4,378 samples analyzed, bacterial growth was observed in 1,921 samples, representing 43.9% of the total. Among the bacterial isolates, Gram-negative bacilli accounted for 73.5%, with Escherichia coli being the most prevalent at 27.9%. Among Gram-positive cocci, Staphylococcus aureus predominated, comprising 25.9% of the isolates. Methicillin-resistant S. aureus exhibited 100% susceptibility to linezolid but low susceptibility to erythromycin (27.0%) and clindamycin (24.0%). E. coli demonstrated high susceptibility to tigecycline (97.4%) and amikacin (75.0%), but lower susceptibility to imipenem (45.0%) and piperacillin-tazobactam (57.8%). Conclusion The substantial wound infection burden and high MDR prevalence in Kashmir necessitate comprehensive antimicrobial stewardship and infection control programs. Regular surveillance, education, and research are crucial to address antibiotic resistance and ensure effective wound infection management in the region.
Abstract
Background Wound infections significantly impact morbidity, mortality, and healthcare costs globally. The Kashmir Valley's unique geographical and climatic conditions, coupled with resource constraints and antibiotic misuse, complicate managing these infections effectively. This study aimed to identify predominant bacterial pathogens in wound infections at a tertiary care hospital in Kashmir, determine their antibiotic susceptibility profiles, and estimate the prevalence of multidrug-resistant (MDR) strains. Materials and Methods A prospective cross-sectional study was conducted from January to June 2023 at the Government Medical College, Srinagar. Pus samples from wound infections were aseptically collected and processed following standard microbiological protocols. Antibiotic susceptibility testing utilized the Kirby-Bauer disk diffusion method, adhering to Clinical and Laboratory Standards Institute guidelines. Data were analyzed using IBM SPSS statistics. Results Out of 4,378 samples analyzed, bacterial growth was observed in 1,921 samples, representing 43.9% of the total. Among the bacterial isolates, Gram-negative bacilli accounted for 73.5%, with Escherichia coli being the most prevalent at 27.9%. Among Gram-positive cocci, Staphylococcus aureus predominated, comprising 25.9% of the isolates. Methicillin-resistant S. aureus exhibited 100% susceptibility to linezolid but low susceptibility to erythromycin (27.0%) and clindamycin (24.0%). E. coli demonstrated high susceptibility to tigecycline (97.4%) and amikacin (75.0%), but lower susceptibility to imipenem (45.0%) and piperacillin-tazobactam (57.8%). Conclusion The substantial wound infection burden and high MDR prevalence in Kashmir necessitate comprehensive antimicrobial stewardship and infection control programs. Regular surveillance, education, and research are crucial to address antibiotic resistance and ensure effective wound infection management in the region.
참고문헌 (31)
- Percival SL, "Slough and biofilm : removal of barriers to wound healing by desloughing", J Wound Care, 24, pp.498~ (2015)
- Trojan R, "Antibiotic susceptibility patterns of bacterial isolates from pus samples in a tertiary care hospital of Punjab, India", Int J Microbiol, 2016, pp.9302692~ (2016)
- Bowler PG, "Wound microbiology and associated approaches to wound management", Clin Microbiol Rev, 14, pp.244~269 (2001)
- Allegranzi B, "Burden of endemic health-care-associated infection in developing countries : systematic review and meta-analysis", Lancet, 377, pp.228~241 (2011)
- Kefale B, "Surgical site infections and prophylaxis antibiotic use in the surgical ward of public hospital in Western Ethiopia : a hospital-based retrospective cross-sectional study", Infect Drug Resist, 13, pp.3627~3635 (2020)
- Frykberg RG, "Challenges in the treatment of chronic wounds", Adv Wound Care(New Rochelle), 4, pp.560~582 (2015)
- Bessa LJ, "Bacterial isolates from infected wounds and their antibiotic susceptibility pattern : some remarks about wound infection", Int Wound J, 12, pp.47~52 (2015)
- Puca V, "Microbial species isolated from infected wounds and antimicrobial resistance analysis : data emerging from a three-years retrospective study", Antibiotics(Basel), 10, pp.1162~ (2021)
- Tamma PD, "Combination therapy for treatment of infections with Gram-negative bacteria", Clin Microbiol Rev, 25, pp.450~470 (2012)
- Uçkay I, "Diabetic foot infections : what have we learned in the last 30 years?", Int J Infect Dis, 40, pp.81~91 (2015)
- Alghizzi M, "The prevalence of Staphylococcus aureus and methicillin resistant Staphylococcus aureus in milk and dairy products in Riyadh, Saudi Arabia", Saudi J Biol Sci, 28, pp.7098~7104 (2021)
- Upreti N, "Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing Gram negative bacilli causing wound infections at a tertiary care hospital of Nepal", Antimicrob Resist Infect Control, 7, pp.121~ (2018)
- Laxminarayan R, "Antibiotic resistance-the need for global solutions", Lancet Infect Dis, 13, pp.1057~1098 (2013)
- Garcia LS, "Clinical Microbiology Procedures Handbook" (2010), ASM Press
- Baron S, "Medical microbiology" (1996), University of Texas Medical Branch at Galveston
- Dawodu OG, "Isolation and identification of microorganisms associated with automated teller machines on Federal Polytechnic Ede campus", PLoS One, 16, pp.e0254658~ (2021)
- Chanda W, "Evaluation of antibiotic susceptibility patterns of pathogens isolated from routine laboratory specimens at Ndola Teaching Hospital : a retrospective study", PLoS One, 14, pp.e0226676~ (2019)
- Idowu OJ, "Extended-spectrum beta-lactamase orthopedic wound infections in Nigeria", J Glob Infect Dis, 3, pp.211~215 (2011)
- Lister PD, "Antibacterial-resistant Pseudomonas aeruginosa : clinical impact and complex regulation of chromosomally encoded resistance mechanisms", Clin Microbiol Rev, 22, pp.582~610 (2009)
- Peleg AY, "Acinetobacter baumannii : emergence of a successful pathogen", Clin Microbiol Rev, 21, pp.538~582 (2008)
- Barlam TF, "Implementing an antibiotic stewardship program : guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America", Clin Infect Dis, 62, pp.e51~e77 (2016)
- Mir BA, "Prevalence and antimicrobial susceptibility of methicillin resistant Staphylococcus aureus and coagulase-negative staphylococci in a tertiary care hospital", Asian J Pharm Clin Res, 6(Suppl 3), pp.231~234 (2013)
- Allegranzi B, "Preventing infections acquired during health-care delivery", Lancet, 372, pp.1719~1720 (2008)
- Aiken AM, "Antibiotic resistance needs global solutions", Lancet Infect Dis, 14, pp.550~551 (2014)
- Lakhundi S, "Methicillin-Resistant Staphylococcus aureus : Molecular characterization, evolution, and epidemiology", Clin Microbiol Rev, 31, pp.e00020-18~ (2018)
- Pang Z, "Antibiotic resistance in Pseudomonas aeruginosa : mechanisms and alternative therapeutic strategies", Biotechnol Adv, 37, pp.177~192 (2019)
- Li XZ, "The challenge of efflux-mediated antibiotic resistance in Gram-negative bacteria", Clin Microbiol Rev, 28, pp.337~418 (2015)
- Nordmann P, "Epidemiology and diagnostics of carbapenem resistance in Gram-negative bacteria", Clin Infect Dis, 69(Suppl 7), pp.S521~S528 (2019)
- Liu YY, "Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China : a microbiological and molecular biological study", Lancet Infect Dis, 16, pp.161~168 (2016)
- Giamarellou H, "Antimicrobial stewardship in the hospital setting : a narrative review", Antibiotics(Basel), 12, pp.1557~ (2023)
- Sakeena MHF, "Non-prescription sales of antimicrobial agents at community pharmacies in developing countries : a systematic review", Int J Antimicrob Agents, 52, pp.771~782 (2018)
