Antimicrobial Resistance Patterns of Wound/Pus Isolates in a Tertiary Care Setting in Bangladesh

Introduction: Wound infection is one of the common and important complication of wound. When the infection is serious or the host is compromised, it needs prolong stay in hospital that results significant increase in costs, morbidity, and mortality. Objective: Bacteria causing wound infection and their sensitivity pattern vary from place to place and it changes frequently over times. Inappropriate use of antimicrobial agents for management of wound infection leads to emergence and spread of drug resistance among the pathogenic bacteria. This study aims to highlights the distribution of bacterial isolates and their antibiotic resistance pattern from wound/pus sample. Materials and Methods: A retrospective analysis of 425 clinical wound/pus samples were received from patient who were visited in outpatient department and were admitted in TMSS Medical College & Rafatullah community Hospital, Bogura from January 2023 to December 2023. The study was conducted at the Microbiology laboratory of same hospital in Bogura. Bacterial isolates were identified by standard conventional microbial technique and antibiotic susceptibility was carried out by modified Kirby-Bauer disc diffusion method. Results: Among 425 patients 153 (36%) were aged 21 to 40 years and 152 (35.76%) were 41 to 60 years. Male (58.12%) were predominant than female (41.88%). Growth was seen in 375 (88.23%) samples out of 425. Out of 375 positive samples, 315 (84%) samples yielded single isolates whereas 60 (16%) samples yielded two isolates, and total isolates of bacteria was 435 in number. Among the isolates, Gram-negative bacilli (GNB) 321 (73.79%) were predominant than Gram-positive cocci (GPC) 114 (26.21%). Klebsiella spp. was highest number about 133 (30.57%) followed by Staphylococcus. aureus109 (25.06%), Pseudomonas 99 (22.76%), then E. coli 51 (11.72%). GNB were highly sensitive to piperacillin-tazobactam combination (85%-100%), gentamycin (54%-90%), amikacin (70-85%) and meropenem (68%-100%) and less sensitive to linezolid (05%-20%), vancomycin (0%-35%), 3 and 4" generation of cephalosporin (10%-40%). Staphylococcus aureus was highly sensitive to co-trimoxazole (82%), vancomycin (74%), linezolid (66%), tigecycline (94%), meropenem (94%), piperacillin-tazobactam combination (95%), amikacin (95%) and less sensitive to ceftazidime (17%), colistin (13%), and aztreonam (14%). Conclusion: The study revealed the most common organism in pus sample was Klebsiella spp. followed by Staphylococcus aureus than Pseudomonas. So, empiric use of antibiotics based on current antibiogram of wound infection of this hospital and strictly monitoring antibiotic stewardship programs in the hospital.