Thesis Abstract

Abstract
Wound infections are a common complication in healthcare settings and can be caused by a variety of aetiological agents. Understanding the microbial profile and antimicrobial susceptibility patterns of these pathogens is crucial for effective management and treatment. This study aimed to identify the aetiological agents of wound infections and determine their antimicrobial susceptibility patterns. A total of 300 wound swab samples were collected from patients presenting with wound infections at a tertiary care hospital. The samples were processed and cultured using standard microbiological techniques. The isolates were identified using biochemical tests and confirmed with advanced molecular methods. Antimicrobial susceptibility testing was performed using the disk diffusion method according to CLSI guidelines. The results revealed a diverse range of microbial pathogens causing wound infections, with the most common isolates being Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae. Methicillin-resistant Staphylococcus aureus (MRSA) was also identified in several samples. The antimicrobial susceptibility testing showed varying resistance patterns among the isolates, with notable resistance to commonly used antibiotics such as penicillin, ciprofloxacin, and erythromycin. However, some isolates remained susceptible to antibiotics like vancomycin, meropenem, and amikacin. Furthermore, multidrug-resistant strains were identified among the Gram-negative bacteria, posing challenges for treatment. Extended-spectrum beta-lactamase (ESBL) production was detected in a significant proportion of Escherichia coli and Klebsiella pneumoniae isolates, further limiting treatment options. The study highlights the importance of continuous monitoring of antimicrobial resistance patterns to guide empiric therapy and prevent treatment failures in wound infections. In conclusion, this study identified the common aetiological agents of wound infections and their antimicrobial susceptibility patterns in a hospital setting. The findings underscore the importance of judicious antimicrobial use and infection control practices to combat the rising threat of antimicrobial resistance. Future research focusing on novel treatment strategies and surveillance of resistance trends is warranted to address the evolving challenges in managing wound infections effectively.

Thesis Overview

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 (Ndipet. 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 (Gottrupet al., 2005; Wilson et al., 2004).