Rijal Basista Prasad, Satyal Deepa, Parajuli Narayan Prasad
Division of Clinical Microbiology, Department of Clinical Laboratory Services, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal.
J Pathog. 2017;2017:9458218. doi: 10.1155/2017/9458218. Epub 2017 Aug 28.
Pyogenic wound infections are one of the most common clinical entities caused and aggravated by the invasion of pathogenic organisms. Prompt and aggressive antimicrobial therapy is needed to reduce the burden and complications associated with these infections. In this study, we intended to investigate the common pathogens and their antimicrobial susceptibility patterns from the pyogenic wound infections at a tertiary care hospital in Kathmandu, Nepal. A laboratory based cross-sectional study was carried out among the pyogenic clinical specimens of the patients visiting Manmohan Memorial Teaching Hospital, Kathmandu, Nepal. Processing of clinical specimens and isolation and identification of bacterial pathogens were carried out using standard microbiological methods. Antimicrobial susceptibilities and resistant profiles were determined by following the standard guidelines of Clinical and Laboratory Standards Institute (CLSI). About 65% of the clinical specimens were positive for the bacterial growth and Gram positive bacteria (57.4%) were the leading pathogens among pyogenic wound infections. (412, 49.28%), (136, 16.27%), spp. (88, 10.53%), and spp. (44, 5.26%) were the common pathogens isolated. High level of drug resistance was observed among both Gram positive bacteria (51.9%) and Gram negative bacteria (48.7%). Gram positive isolates were resistant to ampicillin, ciprofloxacin, cotrimoxazole, erythromycin, and cloxacillin. Gram negative isolates were resistant to cephalosporins but were well susceptible to amikacin and imipenem. Pyogenic wound infections are common in our hospital and majority of them were associated with multidrug resistant bacteria. The detailed workup of the prevalent pathogens present in infected wounds and their resistance pattern is clearly pertinent to choosing the adequate treatment.
化脓性伤口感染是由致病微生物入侵引起并加重的最常见临床病症之一。需要及时且积极的抗菌治疗以减轻与这些感染相关的负担和并发症。在本研究中，我们旨在调查尼泊尔加德满都一家三级护理医院化脓性伤口感染的常见病原体及其抗菌药敏模式。在尼泊尔加德满都访问曼莫汉纪念教学医院的患者的化脓性临床标本中开展了一项基于实验室的横断面研究。使用标准微生物学方法对临床标本进行处理以及对细菌病原体进行分离和鉴定。按照临床和实验室标准协会（CLSI）的标准指南确定抗菌药敏和耐药谱。约65%的临床标本细菌生长呈阳性，革兰氏阳性菌（57.4%）是化脓性伤口感染中的主要病原体。分离出的常见病原体有金黄色葡萄球菌（412株，49.28%）、凝固酶阴性葡萄球菌（136株，16.27%）、肠球菌属（88株，10.53%）和铜绿假单胞菌（44株，5.26%）。革兰氏阳性菌（51.9%）和革兰氏阴性菌（48.7%）中均观察到高水平耐药。革兰氏阳性分离株对氨苄西林、环丙沙星、复方新诺明、红霉素和氯唑西林耐药。革兰氏阴性分离株对头孢菌素耐药，但对阿米卡星和亚胺培南敏感。化脓性伤口感染在我院很常见，其中大多数与多重耐药菌有关。对感染伤口中存在的流行病原体及其耐药模式进行详细分析显然有助于选择适当的治疗方法。
