Isolation of Bacterial Pathogens from Patients with Post Operative Surgical Site Infection and Possible Sources of Infection at University of Gonder Hospital, North West Ethiopia

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Addis Ababa University


Background: Hospital environment is a potential reservoir of bacterial pathogens since it housesboth patients with diverse pathogenic microorganisms and a large number of susceptible individuals. The increased frequency of bacterial pathogens in hospital environment is associated with a background rise in various types of nosocomial infections. Surgical site infection is one of the most frequent types of nosocomial infections in developing countries. The infection follows interference with the skin barrier, and is associated with the intensity of bacterial contamination of the wound at surgery or later in wards during wound care. Bacterial pathogens isolated from hospital environments are also known to develop resistance to multiple antimicrobial agents. The emergence of multi-drug resistant organisms in hospital results in difficulty to treat nosocomialinfections. Objective: The aim of this study was to isolate and identify bacterial pathogens from hospital environments& patients with postoperative surgical site infections and assess the antimicrobial susceptibility patterns of the isolates. Methods: A cross sectional study was conducted at the University of Gondar Teaching Hospital from November 2010-February 2011. In order to address the specified objectives, 220specimens of pus, nasal, hand and surfaces swabs were collected using sterile cotton tippedswabsmoistened with normal saline. Colony characteristics and Gram’s technique were used to differentiate the organisms. Biochemical tests were done to confirm the species of the organisms. Antimicrobial sensitivity tests were done on the isolates using the disk diffusion method. Result: A total of 268 bacterial pathogens were recovered from all specimens processed in the study. Most of the isolates,142(52.9%) were from the environments. The rest,77(28.8%) and49(18.3%) were recovered from the health professionals and patients, respectively. The organisms associated with postoperative surgical site infections were S. aureus 11(22.4%)followed by Klebsiella species 10(20.4%) and Proteus species 9(18.4%), Escherichia coli6(12.2%), Enterobacter species and coagulase negative staphylococci each 4(8.2%),Pseudomonasaeruginosa3(6.1%) and Citrobacterspecies 2(4.1%). Gram negative rods isolatedfrom different sample sources were deemed highly resistant to ampicillin 72(90%),cotrimoxazole, 68 (85%), doxycycline, 66 (82.5%), tetracycline, 63(78.8%),chloramphenicol, 48(60%), nalidixic acid, 46 (57.5%)and gentamicin, 38 (47.5%).S. aureusdemonstrated high level of resistance to nalidixic acid and tetracyclinewhile, ceftriaxone and ciprofloxacin were found tobe relatively effective to all the isolates. Conclusion: The predominant causes of postoperative surgical site infections were S. aureus,Klebsiellaandproteus species. Medical equipment, environmental surfaces, air and hands ofhealth personnel were found to be contaminated with various types of bacterial pathogensofnosocomial importance. It is imperative that all professionals should take an active role in infection control within their organization and more resources should be provided to encourage good antibiotic practice and good hygiene in the hospital.



Bacterial pathogen, postoperative surgical site infection, Hospital environments