Bacteriological profile of surgical site infections and their Antibiogram in surgical wards at tertiary care teaching hospital in Solapur, Maharashtra
Dr. Anu Sharma, Dr. Sonal Agarwal, Dr. DP Danave, Dr. KV Ingole
Background: Surgical site investigations (SSI) is second most common cause of nosocomial infection, due to emergence of resistance among isolates commonly encountered in hospital environment, infection by such microorganisms have resulted in increase in morbidity and mortality among patients, increase hospital stays and increase financial burden on patient. Aim of the study is to determine the bacteriological profile and antibiogram of surgical site infection. Material & Method: The study has been carried out for a period of 3 months from August 2018 to November 2018. All pus samples of clinically suspected of SSI were immediately processed by standard bacteriological techniques. Antibiotic susceptibility testing was done as per CLSI guidelines. Results: Total of 418 samples of patients suspected of SSI was received in Microbiology department. Out of which growth was seen in 296 (70.81%) samples, polymicrobial flora was seen in 21 (5.02%) samples, while 101 (24.2%) were sterile. Most commonly males 178 (60%) were found to be affected by SSI as compared to females 118 (40%). Most common age group affected in both the sexes were elderly patient of more than 60years. Out of 296(70.81%) samples with growth, majority of isolates were gram negative bacilli 196 (66.21%) while gram positive bacteria were 100 (33.78%). Among gram negative bacteria (n=196) most common bacteria isolated was Pseudomonas aeruginosa 50 (25.51%), E. coli 50 (25.51%) followed by Klebsiella pneumoniae 36 (18.4%), Citrobacter koseri 23 (11.73%), Acinetobacter baumannii 22 (11.22 %) Proteusvulgaris 15 (7.65%).Among gram positive bacteria (n=150) 33.78%. Most common bacteria isolates were MRSA were 60 MSSA 28 and Enterococcus faecalis 12(12%). Among gram negative bacteria maximum sensitivity was seen for imipenem 59% followed by Amikacin 58.2%, Piperacillin-tazobactam 43.4%, Ciprofloxacin 41.32%, Cefotaxime 38% and Ceftazidime 34%. Among gram positive bacteria Staphylococcusaureus showed high resistance to Cefoxitin (68.18%), followed by Erythromycin 57%, Clindamycin 47%, Ciprofloxacin 36.4%, Gentamicin 23.86%. while 100% sensitivity was seen for Vancomycin and Linezolid respectively. Among gram negative bacteria 81 (41.32) isolates were imipenem resistant of which 54 (27.55%) were MBL (Metallo beta lactamases) producers which was confirmed by EDTA disc synergy test and Modified hodge test, while 60 (52.2%) isolates were ESBL producer confirmed by combined disc test and 30 (26.1%) isolates were Amp-c producers confirmed by Amp-c disc test, While 12 (10.43%) isolates were both ESBL and Amp-C producers.