ABSTRACT
Background: Wound infections have been a problem in the field of surgery for a long time. Advances in control of infections have not completely eradicated this problem because of development of drug resistance.Antimicrobial resistance can increase complications and costs associated with procedures and treatment. Objective: A study was carried out on drug sensitivity patterns of bacterial isolates from septic postoperative wounds in Jinja hospital; Uganda.This study was designed to determine the distribution of bacterial pathogens isolated from septic post-operative wounds and their antimicrobial susceptibility patterns. Method: Specimens of pus swabs were collected aseptically and analysed in the laboratory. Colony characteristics and Grams technique were used to differentiate the organisms. Biochemical tests were done to confirm the species of the organisms. Sensitivity testing was done on the isolates using the disk diffusion method. Results: Pathogenic bacteria were recovered from 58.5of the specimens.The isolates were: S.aureus (45.1); Coliforms (16.9); Proteus mirabilis (11.3); P.aeruginosa (9.9); Klebsiella pneumoniae (7.0) and Enterobacter spp (2.82). Most of the orga- nisms were sensitive to gentamicin; ciprofloxacin and ceftazidime.There was resistance to ampicillin; amoxycillin and chloramphenicol. Staphylococcus aureus was generally sensitive to gentamicin (87.5); ciprofloxacin (68.7) and methicillin (75); but resistant to erythromycin (56.2) and ampicillin (97). Most of the gram-negative bacteria isolated (Coliforms; P.aeruginosa ; E.coli ; Proteus mirabilis ; and Klebsiella pneumoniae ) were sensitive to Ciprofloxacin; Gentamicin and Ceftazidime but resistant to Ampicillin;Amoxycillin and Chloramphenicol. Methicillin-resistant Staphylococcus aureus (MRSA) strains formed 25of this species. Pseudomonas aeruginosa was sensitive to gentamicin (87.5) and ceftazidime (85.7) but showed resistance to ciprofloxacin (57.2). Some organisms e.g. S.aureus; Pseudomonas aeruginosa and Proteus mirabilis exhibited multi-drug resistance to the antibiotics tested. Conclusion: Since a high proportion of samples had positive cultures; infection control is recommended as a strategy to minimise spread of resistant organisms. It is recommended that gentamicin; ciprofloxacin and ceftazidime be used in preference to ampicillin and amoxycillin for treatment of septic wounds.There is need to develop national surveillance of antibiotic- resistant organisms
Subject(s)
Drug Hypersensitivity , Surgical Wound Infection , Wounds and InjuriesABSTRACT
Background: Urinary tract infections (UTIs) are among the most common human infections. Many urinary tract bacteria are capable of expressing drug resistance. Resistant bacteria may be present from the commencement of the infection or may develop during treatment. This study focused on the problem of antibiotic resistance to the first-line drugs that were used to treat patients presenting with urinary tract infections at Rubaga hospital in Kampala; Uganda. Objectives: The objective of this study was to isolate and identify the major bacterial pathogens of symptomatic and asymptomatic UTIs among patients at Rubaga hospital. Furthermore; the study sought to determine the antimicrobial susceptibility patterns of the major bacterial isolates to the first-line drugs used to treat UTIs at Rubaga hospital. Methods: Urine samples were aseptically collected and exami- ned microscopically and were microbiologically cultured on blood agar; nutrient agar and on MacConkey agar. The isolates obtained were then identified using standard tests and tested for antimicrobial sensitivity by the Kirby-Bauer technique. Results: The isolated pathogens included Escherichia coli (10.9); Staphylococcus (31.9); Streptococcus (9.2); Klebsiella species (21.0) and Proteus species (10.1). 20 (16.8) of the isolates were lactose fermenting gram-negative rods that were also indole-negative. These isolates were termed 'unclassified coliforms' in this study but were probably Enterobacter species. On antimicrobial susceptibility testing; all the gram-negative isolates were significantly resistant to amoxycillin; cotrimoxazole; erythromycin; and to nalidixic acid; but were susceptible to nitrofurantoin. Among the gram-negative isolates; only Klebsiella species were significantly resistant (p0.05) to ciprofloxacin. The gram-positive cocci were susceptible to amoxycillin; ciprofloxacin; and to erythromycin but resistant to cotrimoxazole and nalidixic acid. Unlike the Staphylococcus species that were significantly resistant to nitrofurantoin; Streptococcus species were moderately susceptible to the drug. Conclusion: The common urinary tract bacteria detected in Rubaga hospital in Uganda were most sensitive to Ciprofloxacin and Nitrofurantoin