Prevalence of infected chronic wound isolates and their Minimum inhibitory concentrations against third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda

Abstract

Background: Globally, the burden of infected chronic wounds is likely to increase due to the rising levels of bacterial resistance to antibiotics and non-communicable diseases such as Diabetes mellitus and cancer. Furthermore, the burden of antibiotic resistant strains in infected chronic wounds is likely to increase especially in resource constrained areas like Mbarara regional referral Hospital where the selection of antibiotic therapy does not usually depend on known antibiotic susceptibilities. Therefore, the objectives of this study were; (I) to determine the prevalence of infected chronic wounds isolates from patients admitted in the surgical ward of MRRH, Uganda and (II) to determine the MIC of infected chronic wound isolates against the third generation cephalosporins. Method(s): This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Wound swabs were aseptically collected, registered in the laboratory register and depending on the nature of samples; each specimen was inoculated on chocolate, blood, mannitol salt sugar, xylose lysine decarboxylated agar, and MacConkey Agar and incubated at 350C-370C in the incubator. Broth microdilution method was used to test for MIC. The collected data was entered into Microsoft Excel and exported to STATA version 15.0 for statistical analysis. Chi square/Fishers’s Exact test and analysis of variance (ANOVA) tests were used to analyse data for objective 1 and 2 respectively Results: The most prevalent pathogens isolated were staphylococcus aureus (40.6%,) and Klebsiella spp (29%,) while the least prevalent pathogens were Providencia spp(1.4%, n=1/69) and Enterobacter agglomerans(2.9%, n=2/29). Generally, staphylococcus aureus exhibited the lowest MIC against cefoperazone+sulbactum 2g (Sulcef®) and ceftriaxone 1g (Epicephin®) (4.33±8.41μ/ml and 15.77±23.32μ/ml respectively). However, the differences in mean MIC observed across various groups were not statistically significant (P >0.05). Conclusion: The most prevalent pathogens isolated from patients with infected chronic wounds at the surgical ward of MRRH were Staphylococcus aureus, Klebsiella spp and proteus spp and the most effective third generation cephalosporins were cefoprazone+sulbactam 2g and ceftriaxone 1g (Epicephin®) while the most ineffective antibiotics were cefpodoxime 200mg and cefixime 400mg.