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Prevalence of Multidrug Resistant Bacteria in Postoperative Wound Infections at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Getachew Seyoum Asres, Melese Hailu Legese, Gebru Mulugeta Woldearegay

Background: Postoperative wound infections are major problems throughout the world. Moreover, multidrug resistance (MDR) bacteria pose challenges for control. Hence, this study aimed to determine the prevalence of multidrug resistant bacteria from postoperative wound infections.

Methods: A cross-sectional study was conducted from March to August 2015. A total of 197 patients who developed postoperative wound infections after surgery were included. Wound swabs were collected using sterile cotton swabs and dipped into sterile amines transport media. All samples were cultured on blood, MacConkey and mannitol salt agar. Culture positive samples were characterized by gram stain, colony morphology and standard biochemical tests. Antimicrobial susceptibility testing was performed on Muller-Hinton agar using disk diffusion. Data was analyzed using SPSS version 20.

Results: Overall bacterial prevalence was 75.6% (n=149/197) and predominant bacterial isolates were Staphylococcus aureus 33.3% (n=56/168) and Escherichia coli 14.3% (n=24/168). Double infections were seen 11.4% (n=17/149) of which 23.5% (n=4/17) Staphylococcus aureus and Pseudomonas spp. occurred together. Highest proportion of bacteria 28.2% (n=42/149) were isolated from orthopedics department followed by general surgery 24.8% (n=37/149). Of all bacterial isolates, the multidrug resistance level was 65.5% (n=110/168). Gram positive and Gram negative bacteria showed an MDR level of 55.3% (n=42/76) and 73.9% (n=68/92) respectively. Amoxicillin (93.5%), ceftriaxone (85.3%) and penicillin (84.5%) were least effective.

Conclusion: Aseptic surgical practice and standard operating procedures for wound management should be followed to minimize postoperative wound infections. The possible choices of antibiotic options for treatment of postoperative wound infections are few hence for preventing further emergence and spread of MDR bacteria rational use of antibiotics and regular monitoring of antimicrobial resistance patterns is essential.