Susceptibility Trend of MDR Gram Negative Isolates From Infected Wounds of Hospitalized Patients in Tertiary Care Hospital South Punjab

Background: Wound infections remain a significant cause of delayed healing and increased morbidity in hospitalized patients. The presence of devitalized tissue and moist wound environments provide an ideal niche for microbial colonization and infection. Gram-negative bacteria are particularly associated with hospital-acquired infections, and their growing resistance to multiple antibiotics has become a critical concern in clinical management. Objective: To isolate Gram-negative bacterial strains from infected wounds of hospitalized patients and determine their antibiotic susceptibility patterns. Methods: This cross-sectional study was conducted at the Department of Pathology, Combined Military Hospital (CMH) Multan. A total of 170 wound swab samples were collected aseptically using sterile cotton swabs in Amies transport medium. All samples were cultured on Blood agar and MacConkey agar and incubated at 37°C for 24 hours. Gram-negative isolates were further identified using standard biochemical tests including oxidase, indole, MR-VP, citrate, urease, and TSI. Antibiotic susceptibility testing was performed using six commonly prescribed antibiotics. Data were entered and analyzed using SPSS version 25. Frequencies and percentages were calculated, and chi-square was applied where appropriate with p ≤ 0.05 considered significant. Results: Out of 170 samples, 135 (79.4%) were culture positive, with 110 (81.4%) yielding Gram-negative rods and 25 (18.5%) Gram-positive cocci. The most frequently isolated pathogen was Pseudomonas aeruginosa (33.3%), followed by E. coli (14.07%), Proteus (13.3%), Enterobacter (11.8%), Citrobacter (5.18%), Klebsiella (2.22%), and Acinetobacter (1.4%). E. coli exhibited high resistance to ciprofloxacin (73.6%) and amoxicillin-clavulanate (68.4%), while remaining sensitive to cefepime (84.2%) and amikacin (84.2%). Conclusion: This study highlights the increasing prevalence of multidrug-resistant Gram-negative bacteria in wound infections. Judicious antibiotic use and routine microbial surveillance are essential to curb the spread of resistant strains in hospital settings.