Surgical Wound Infection in Tikur Anbessa Hospital with Special Emphasis on Pseudomonas Aeruginosa
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Date
2008-04
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Addis Ababa University
Abstract
Pseudomonas aeruginosa surgical site infection is a serious infection with significant patient mortality and health-care costs. The emergence of multidrug resistant strains of Pseudomonas aeruginosa has complicated treatment decisions and leads to treatment failures. In Ethiopia, few studies were conducted and even those studies were done generally on gram-negative bacteria not specifically on Pseudomonas aeruginosa from surgical sites despite the fact that P.aeruginosa is becoming serious cause of opportunistic infection in immunocompromised and hospitalized post operative patients. Nevertheless, the relationship between appropriate antimicrobial treatment and clinical outcome is not well established in
Tikur Anbessa hospital. This is a prospective study of surgical wound infection on surgical patients operated from April to July 2006 in Tikur Anbessa hospital. A total of 173 patients were enrolled and clinical samples collected for analysis. Demographic data and laboratory analysis test on the occurrence of Pseudomonas aeruginosa wound infection rate and antimicrobial susceptibility patterns has been conducted in the first 30 days postoperatively. Among the patients, there were 97(56%) male patients and 76(44%) female patients. The mean age of the patients was 37.3(range: 1-80 years). The infection rate was 10.3%, 13.6%, 22.7% and 36.8% for clean, clean-contaminated, contaminated and dirty wounds respectively. The rate of surgical site infection was 17.9% with Pseudomonas aeruginosa being 14.4% of all the isolates. On comparing infected patients (n=31) with non-infected patients (n=142), there was no significant difference in the frequency of infection by sex (p= 0.11). Pseudomonas aeruginosa was the third dominant
isolates following Staphylococcus aureus and coagulase negative Staphylococci respectively. The prevalence of drug resistance to Amikacin, Azeotronam, Ceftriaxone, Ceftazidime, Chloroamphenicol, Ciprofloxacine, Gentamicin, Imipene, Piperacillin, Tetracycline and Trimethoprim Sulfamethoxazole was evaluated. The minimum resistance rate was 25% for Amikacin and Imipenem and the highest resistance rate obtained was for Chloroamphenicol which was 100%. 87% of the isolates of P.aeruginosa were multidrug resistant. The outcome of this research emphasizes the use of first line drug therapy rather than random prescription of antibiotics with out susceptibility 9 testing. This will aggravate the ever increasing resistance not only to Pseudomonas aeruginosa but also to other microorganisms. Policies governing the use of antimicrobials in many institutions are lacking. Such policies must be implemented in order to limit the spread of resistance.
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Pseudomonas Aeruginosa