Antimicrobial susceptibility patterns of bacteria isolated from infected wounds at Mbale regional referral hospital, Uganda

Abstract

Background: Wound infections are a major cause of morbidity and are increasingly complicated by antimicrobial resistance. This study determined the bacterial etiology and antimicrobial susceptibility patterns of wound infections at a regional referral hospital in Eastern Uganda. Methods: A laboratory-based cross-sectional study was conducted at Mbale Regional Referral Hospital between May and August 2023. Wound swabs from 210 patients with clinically suspected wound infections were cultured, bacterial isolates identified using standard microbiological methods, and antimicrobial susceptibility testing performed according to CLSI 2023 guidelines. Results: Bacterial growth was detected in 41.9% (88/210) of wound swabs. Gram-negative organisms predominated, accounting for 61.4% (54/88) of isolates. The most common pathogens were Escherichia coli (22/88, 25.0%), Staphylococcus aureus (18/88, 20.5%), coagulase-negative staphylococci (14/88, 15.9%), and Klebsiella pneumoniae (13/88, 14.8%). MRSA prevalence among S. aureus isolates was 61.1% (11/18; 95% CI: 35.8-82.7%). High resistance was observed to ampicillin, ceftriaxone, gentamicin, and ciprofloxacin. Overall, 28.4% (25/88) of isolates were multidrug resistant. Conclusion: Wound infections at Mbale Regional Referral Hospital were characterized by Gram-negative predominance and substantial antimicrobial resistance, including high MRSA and multidrug resistance rates. Routine microbiological testing, infection prevention measures, and antimicrobial stewardship are needed to support effective wound infection management.