Microbiological Profile and Antimicrobial Resistance of Surgical Wound Infections in a Tertiary Hospital in Azerbaijan

Background Surgical wound infections are a common healthcare-associated complication and are complicated by antimicrobial resistance, which limits empirical treatment options. Local pathogen and susceptibility data are needed to guide empirical therapy and stewardship in Azerbaijan. Aim To describe the microbiological profile of surgical wound cultures and the antimicrobial susceptibility patterns of recovered isolates in a tertiary hospital in Azerbaijan. Methods A retrospective laboratory-based study was conducted from August to December 2024 using surgical wound culture records and susceptibility data. Antimicrobial susceptibility testing was performed by disk diffusion and MIC-based methods and interpreted according to EUCAST criteria. Findings Out of 344 surgical wound culture records 45 had no microbial growth, 299 were analysed. The most frequent microorganisms were Staphylococcus aureus (84/299, 28.1%), Pseudomonas aeruginosa (54/299, 18.1%), Staphylococcus epidermidis (24/299, 8.0%), Klebsiella pneumoniae (22/299, 7.4%), and Escherichia coli (19/299, 6.4%). Among S. aureus isolates, 13/84 (15.5%) were MRSA. All tested S. aureus isolates were susceptible to vancomycin and linezolid. P. aeruginosa showed the highest susceptibility to meropenem (90.7%), amikacin (85.2%), and imipenem (82.7%). Among Enterobacterales, carbapenems showed the highest overall in vitro activity in the tested panels. Of 195 isolates eligible for MDR/XDR assessment, 93 (47.7%) were MDR, including 8 (4.1%) possible XDR, and 2 (1.0%) as confirmed XDR. Conclusion Surgical wound cultures were dominated by S. aureus and non-fermenting Gram-negative bacilli. Given increasing resistance, particularly among Gram-negative pathogens and persistent surveillance gaps, these findings support routine culture-based diagnosis and use of local susceptibility data to guide empirical therapy and antimicrobial stewardship.