Antibiotics Sensitivity Pattern of Post-Operative Wound Infections in a Tertiary Care Hospital, Western Nepal

Abstract Background: Surgical site infections (SSIs) is one of the most common postoperative complications and cause significant postoperative morbidity, mortality, prolong hospital stay and increase in hospital cost. The condition is serious in developing countries like Nepal owing to irrational prescriptions of antimicrobial agent. SSIs in those countries rates from 2.5% to 41.9%. This study was performed to find the common organisms causing surgical site infections and their antibiotics sensitivity pattern in a tertiary care hospital, western Nepal.Materials and methods: Pus or swab samples collected from suspected post- operative wound infections and submitted for culture and sensitivity in the Department of Microbiology were included in this study. Isolation and identification of the organisms was done as recommended by American society of microbiology (ASM). Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method as recommended by Clinical Laboratory Standard Institute (CLSI) guideline.Results: Out of 152 pus and swab samples processed for culture, (64.5%) showed culture positivity. In total isolates (65.7%) were Gram negative bacteria and (34.3%) Gram positive bacteria. Staphylococcus aureus (23.9%) was the predominant Gram positive isolate and Escherichia coli (18%) was the major Gram negative isolate. S. aureus showed (100%) sensitivity towards Linezolid and (94.4%) towards Vancomycin. Among commonly used antibiotics for Gram positive bacteria Penicillin (94.4%), Erythromycin (80.5%) were highly resistant. Sixty percent of Staphylococcus aureus isolated showed methicillin resistant (MRSA). Gram negative bacteria showed (100%) sensitivity towards the Colistin sulphate and Polymyxin B and were highly resistant towards Ampicillin (98.2%), Cefexime (87.3%), Ceftriaxone (87.3%) and other commonly used antibiotics. Overall multi-drug resistance was found in (89.5%) isolates. Among Gram negative bacterial isolates (23.1%) were MBL producer and (21.7%) were ESBL producer.Conclusion: Culture positivity in suspected case of SSIs was high (65.1%). Staphylococcus aureus was the common causative agent of SSIs. Bacteria showed more than 50% resistance towards commonly used antibiotics. So for the selection of appropriate antibiotic for better treatment of patients, culture and sensitivity should be done in every suspected case of SSIs.