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Chronic wound isolates and their minimum inhibitory concentrations against third generation cephalosporins at a
Khalim Wangoye1, James Mwesigye2, Martin Tungotyo3
1Department of Pharmacy and Pharmacology, Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda. khalimwags@gmail.com.
Abstract:
Globally, the burden of chronic wound infections is likely to increase due to the rising levels of bacterial resistance to antibiotics. In the United States of America alone, more than 6.5 million chronic wounds with evidence of bacterial infection are diagnosed every year. In addition, the polymicrobial environment in chronic wound infections has been observed from several studies as a risk factor for development of resistance to many antibiotics including the third generation cephalosporins currently used in Mbarara Regional Referral Hospital for treatment of chronic wound infections. Therefore the main objective of this study was to determine the prevalence of chronic wound isolates and their minimum inhibitory concentrations (MIC) against third generation cephalosporins. This study was a cross-sectional descriptive and analytical survey of bacterial isolates from chronic wound infection among 75 study participants admitted in the surgical ward of Mbarara Regional Referral Hospital (MRRH), a tertiary Hospital in Western Uganda. Standard laboratory bacterial culture and identification techniques as well as broth microdilution method were used to isolate, identify pathogens and test for MIC respectively. We found that 69/75 study participants had samples with bacterial growth and the most prevalent pathogens isolated were staphylococcus aureus (40.6%) and Klebsiella spp. (29%). Generally, most isolates were susceptible to cefoperazone + sulbactum 2 g (Sulcef) and ceftriaxone 1 g (Epicephin). The overall prevalence of isolates in chronic wound infection among patients admitted in the surgical ward of MRRH was 92% and the most prevalent isolates were Staphylococcus aureus, Klebsiella species and proteus species respectively. The observed MIC values were higher than the CLSI clinical breakpoint, implying a decreasing trend in susceptibility of chronic wound isolates to third generation cephalosporins.
Insights
Bacterial resistance to antibiotics is rising, increasing chronic wound infections. This study found high prevalence of resistant bacteria in Ugandan hospital patients, with decreasing susceptibility to common cephalosporin antibiotics.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Chronic wound infections pose a growing global health challenge, exacerbated by increasing bacterial resistance to antibiotics.
- Polymicrobial infections in chronic wounds are linked to antibiotic resistance, including to third-generation cephalosporins used in treatment.
- Mbarara Regional Referral Hospital (MRRH) faces challenges in treating chronic wound infections due to these factors.
Purpose of the Study:
- To determine the prevalence of bacterial isolates in chronic wound infections at MRRH.
- To evaluate the minimum inhibitory concentrations (MIC) of third-generation cephalosporins against these isolates.
- To assess the susceptibility patterns of chronic wound pathogens to specific cephalosporin antibiotics.
Main Methods:
- A cross-sectional descriptive and analytical survey was conducted with 75 patients in the surgical ward of MRRH.
- Standard bacterial culture and identification techniques were employed.
- Broth microdilution method was used to determine MIC values for third-generation cephalosporins.
Main Results:
- A high prevalence of bacterial growth (92%) was observed in chronic wound samples.
- The most prevalent pathogens identified were Staphylococcus aureus (40.6%) and Klebsiella spp. (29%).
- Most isolates showed susceptibility to cefoperazone + sulbactam and ceftriaxone, but observed MIC values exceeded clinical breakpoints, indicating reduced susceptibility.
Conclusions:
- Third-generation cephalosporins are crucial for treating chronic wound infections, but resistance is a growing concern.
- Staphylococcus aureus and Klebsiella spp. are significant pathogens in chronic wound infections at MRRH.
- There is a concerning trend of decreasing susceptibility of chronic wound isolates to third-generation cephalosporins, necessitating further investigation and potential treatment strategy adjustments.
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