The Pattern Of Susceptibility Test In Wound Infections
The Pattern Of Susceptibility Test In Wound Infections
ABSTRACT
Wound infection continues to be problematic in clinical practice where empirical treatment of infection is routine. A wound is defined as any injury that damages the skin and therefore compromises its protective function. A retrospective study to determine the causative organisms of wound infections and their antimicrobial susceptibility pattern in the Hopes hospital and laboratory, Nnewi, Anambra State of Nigeria.
Records of wound swabs collected from 60 patients with high suspicion of wound infection were analysed. Smears of the wound swabs were inoculated on appropriate media and cultured. Bacterial isolates were Gram stained and microscopically examined. Biochemical and sugar fermentation tests were done to identify pathogen species. The Kirby-Bauer disk diffusion method was used for antibiotic testing.
Prevalence of wound infection was 83.3%. Most bacteria were Gram negative rods with Klebsiella pneumoniae being the most prevalent pathogen isolated. The bacterial isolates exhibited a high degree of resistance to antibiotics tested (50% – 100%). All isolates were resistant to zinnacef and tarivid and almost all the isolates were susceptible to streptomycin.
There was a significant association between the age group and the aetiological agent. Sex did not exert any effect on the prevalence, aetiological agent or antimicrobial resistance pattern. I suggest a multidisciplinary approach to wound management, routine microbiological surveillance of wounds, rational drug use and institution of strong infection control policies.
TABLE OF CONTENTS
Title page
Certification i
Dedication ii
Acknowledgment iii
Abstract iv
Table of contents v
List of tables viii
List of figure ix
Appendix x
CHAPTER ONE
Introduction 1
CHAPTER TWO
Literature review 4
CHAPTER THREE
Materials and methods 11
- Materials for the study 11
- Area of the study 11
- Sampling Area 11
- Sample used 11
- Inclusion criteria 11
- Exclusion criteria 12
- Number of Samples 12
- Sample Collection 12
- Time of collection 12
- Site of the wound 12
- Types of wound 12
- Media used for study 12
- Preparation of media 13
- Control 13
- Inoculation of wound sample 14
- Incubation of inoculated plates 14
- Subculturing of colonies 14
- Preservation of pure cultures 15
- Identification of isolates 16
- Microscopic identification 16
- Biochemical tests 17
- Antisusceptibility testing 21
CHAPTER FOUR
Results 22
Discussion 35
CHAPTER FIVE
Conclusion 36
Recommendation 37
References 38
Appendix 39
INTRODUCTION
The primary function of intact skin is to control microbial population that live on the skin surface and to prevent underlying tissue from becoming colonized and invaded by potential pathogens (Ndip et. al., 2007). Exposure of subcutaneous tissue following a loss of skin integrity (i.e. wound) provides a moist, warm and nutritious environment that is conducive to microbial colonization and proliferation.
A wound is defined as any injury that damages the skin and therefore compromises its protective function. An acute wound is generally caused by external damage to the skin, including abrasions, minor cuts, lacerations, puncture wounds, bites, burns and surgical incisions. A wound is a breakdown in the protective function of the skin; the loss of continuity of epithelium, with or without loss of underlying connective tissue (Leaper and Harding, 1998).
Wounds can be accidental, pathological or post operative. All wounds contain bacteria but majority of the wounds do no get infected. There are many variables that can promote wound infection when there is a discontinuity of skin barrier. This include both host and organism related factors like bacterial load and type, immune competence of host co-morbid like diabetes mellitus, etc (Mir et. al., 2012).
An infection of this breach in continuity constitutes wound infection. Wound infection is thus the presence of pus in a lesion as well as the general or local features of sepsis such as pyrexia, pain and indurations. Wound infections are one of the most common hospital acquired infections and are an important cause of morbidity and account for 70-80% mortality (Gottrup et al., 2005; Wilson et al., 2004).
REFERENCES
Alan, J. (2015). Chemistry: An Introduction For Medical And Health Sciences. (10th Edition) John Wiley & Sons Usa. Pp. 5–6.
Adamu, M. A., Weck, M. N., Gao, L., Brenne, H. (2010). Incidence Of Chronic Atrophic Gastritis: Systematic Review And Meta-Analysis Of Follow-Up Studies European Journal Of Epidemiology25(7):439–448.
Best, R., Lewis, D.A And Nasser, N. (2004). The Anti-Ulcerogenic Activity Of The Unripe PlantainBanana (Musa Species). Br J Pharmacol.82(1):107-16.
Brunicardi, F., Charles, A., Dana, K. (2010). Schwartz’s Principles Of Surgery (9th Edition). Mcgraw- Hill, Medical Pub. New York: Pp 32-40.
Chinatamby, S.C. (2011). Last’s Anatomy (12th Edition) Churchill Livingstone Elsevier Publishers New Dehli India: Pp 256-266.
Calam, J And Baron, J. H. (2001). Pathophysiology Of Duodenal And Gastric Ulcer And Gastric Cancer. Abc Of The Upper Gastrointestinal Tract (2nd Edition). Jaype Publishers New Dehli India: Pp60-85.
Davis, C.P. (2015). Gastritis. Http://Www.Medicinenet.Com/Gastritis/Article.Htm.
Drake, R. A., Wayne, V., Adam, W. M. (2009) Gray’s Anatomy For Students. (2nd Edition). Elsevier Health Sciences Publisher New York: Pp165.
Daniels, I. R. And Allum, W. H.(2010). The Anatomy And Physiology Of The Stomach (3rd Edition). Elvisier Publishers: 2-40.
Ezekwesili, C.N., Ghasi, S., Adindu, C.S., Mefoh, N.C.(2004). Evaluation Of The Antiulcer Property Of Aqueous Extracts Of Unripe Musa Paradisiacal Linn. Peel In Wistar Rats. African Journal Of Pharmacy And Pharmacology. 8(39): 1006-1011.
Giri (2015) Hematoxylin And Eosin Staining : Principle, Procedure And Interpretation. Http://Laboratoryinfo.Com/Hematoxylin-And-Eosin-Staining/
Gore, R.M. And. Levine, M. S. (2007). Textbook Of Gastrointestinal Radiology.(2nd Edition). Saunders Pub Philadelphia:Pp 15-30
Gray H, Lewis Wh. (2000).Gray’s. Anatomy Of The Human Body. (20th Edition). Bartleb New York: Pg 123-150.
Kulkarni, M.V.(2012). Clinical Anatomy. (2nd Edition). Jaypee Publishers India: Pg 415-422.
Micromedex, (2016). Drugs And Supplements Indomethacin (Rectal Route). Https://Www.Mayoclinic.Org/Drugs-Supplements/Indomethacin-. . .. . Rectalroute/Description.
Omogba,I E.K., Ozolua, R.I., Idaewo, P.E., Isah, A.O (1999). Some Studies On The Rodenticidal Action Of Indomethacin. Drug Chem Toxicol. (4):629-42.
Sherwood And Lauralee (2007). Human Physiology: From Cells To Systems. (6th Edition). Belmontwadsworth Pub Germany: Pp 62-70.
Stack, W.A, Atherton, J.C, Hawkey, G.M, (2006). Interactions Between Helicobacter Pylori And Other Risk Factors For Peptic Ulcer Bleeding. Aliment Pharmacology. 16:497–506.
Starpoli, A.A. (2015). Peptic Ulcer Disease. Http://Www.Starpoli.Com/Peptic.
