Prevalence of Multidrug Resistant Bacteria Isolated from Wound Infection in a Tertiary Care Hospital at Rajshahi

Abstract

Background: Multidrug resistant bacteria is a major and on-going public health problem both globally and locally. The threat of multidrug resistant bacteria is recognised as the most dead listed bacteria in the world. Most of the multidrug resistant bacteria are resistant to commonly used antibiotics including 3rd generation of cephalosporins, fluorquinolones and carbapenems. So treatment of different infections caused by multidrug resistant bacteria are gradually becoming more difficult and it also increased the mortality and morbidity. Objective: The aim of the study was to detect multidrug resistant bacteria isolated from infected wound patients in Rajshahi region. Methods: Cross sectional type of descriptive study was done during the period of July 2017 to June 2018. Wound swab were collected in different surgical units of Rajshahi Medical College Hospital. The specimens were inoculated in blood agar, nutrient agar and MacConkey’s agar plates and incubated aerobically at 370 C for 24 hours. Bacterial isolates were identified and susceptibility test was done by using the modified Kirby Bauer disk diffusion method on Mueller Hinton agar plates. Multidrug resistant bacteria was identified by disk diffusion method against different classes of antimicrobials agents. Results: Out of total 250 wound samples, culture yielded growth in 213(85.2%) cases. Among 213 isolates, 136 (58.8%) were gram negative and 95 (41.2%) were gram positive bacteria. Maximum 118 (47.2%) cases were within the age group of 19-30 years and show growth in 98 (39.2%) cases of which males were 29 (11.6%) and females were 69 (27.6%). Among the isolated bacteria S. aureus was 71 (30.8%), E.coli 48 (20.8%), P.aeruginosa 47 (20.3%) and Klebsiella spp. 20 (8.7%). Out off, 231 bacterial isolates, 135 (58.4%) were identified as MDR. The overall MDR among gram positive and gram negative bacterial isolates were 55.8% and 60.3% respectively. Among gram positive bacteria identified as MDR were 39 (55%), 08 (57.1%) and 06 (60%) respectively. Among gram negative bacteria e.g.E.coli, P. aeruginosa, Klebsiellaspp., Proteus spp. and Acinenobacter spp. were 28(58.3%), 30(63.8%), 12 (60%), 08(57.1%) and 04(57.1%) identified as MDR. Vancomycin, linezolid and imipenem were the most sensitive drugs against gram positive and colistin & imipenem against gram negative bacteria. Conclusion: This study indicated that MDR of bacterial isolates of wound infection was very high and many of them were also identified as resistant to three or more classes of antimicrobials agents. Such widespread resistance to antimicrobial classes is something serious and few treatment options remain for these patients. Now the time has come to take urgent action other wise we are heading to a post- antibiotic era in which common infections and minor injuries can kill may live. Strict healthpolicies should be applied to use antibiotics, continuously monitor and report antibiotic resistance.