Omoyibo Eguono Erhinyaye, Oladele Ayodeji Olarewaju, Ibrahim Muhammad Habib, Adekunle Oluwakayode Temitope
Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria.
Department of Surgery, Federal Medical Center, Birnin Kebbi, Kebbi State, Nigeria.
Ann Afr Med. 2018 Jul-Sep;17(3):110-116. doi: 10.4103/aam.aam_22_17.
Wounds are commonly encountered in the clinical practice. Microbacterial colonization and infection negatively affect wound outcomes. With increasing emergence of antibiotic-resistant strains, it is essential to determine local patterns of wound microbiological profile and antibiotic susceptibility to guide rational empirical antibiotic use.
Consecutive patients who presented to the plastic surgery unit were recruited to the study over a 6-month period. Wound swab cultures were performed at presentation using standard protocols and media. The wound swab was performed by the Levine technique and data were analyzed using a statistical software package.
Eighty-five microbial isolates were obtained from the eighty patients (55 males and 25 females) recruited. Gram-positive isolates were 35 (41.2%) and Gram-negative were 50 (58.8%). There was equal distribution of acute and chronic wounds. Pseudomonas aeruginosa was the most common isolate at 30.6%, followed by Staphylococcus aureus (27.1%), Escherichia coli (9.4%), Streptococcus species (8.2%), and Morganella morganii (7.1%). The isolates demonstrated resistance to amoxicillin-clavulanate, ampicillin, cloxacillin, cefuroxime, ceftazidime; low-to-moderate sensitivity to erythromycin, gentamicin, streptomycin, tetracycline, ciprofloxacin, and ofloxacin; and a moderate sensitivity to ceftriaxone and a high sensitivity to imipenem. There was significant difference in antibiotic resistance patterns between Gram-positive isolates from acute and chronic wound infections but not for acute and chronic wound Gram-negative isolates.
Most of the microbial isolates, particularly the Gram-negative isolates demonstrated low sensitivity to commonly used antibiotics and moderate-to-high sensitivity to less commonly used newer antibiotics.
伤口在临床实践中很常见。微生物定植和感染会对伤口愈合结果产生负面影响。随着抗生素耐药菌株的不断出现，确定伤口微生物谱的局部模式和抗生素敏感性以指导合理的经验性抗生素使用至关重要。
在6个月的时间里，连续招募到整形外科就诊的患者参与本研究。就诊时采用标准方案和培养基进行伤口拭子培养。伤口拭子采用莱文技术采集，数据使用统计软件包进行分析。
从招募的80名患者（55名男性和25名女性）中获得了85株微生物分离株。革兰氏阳性分离株有35株（41.2%），革兰氏阴性分离株有50株（58.8%）。急性和慢性伤口分布均等。铜绿假单胞菌是最常见的分离株，占30.6%，其次是金黄色葡萄球菌（27.1%）、大肠杆菌（9.4%）、链球菌属（8.2%）和摩根摩根菌（7.1%）。这些分离株对阿莫西林 - 克拉维酸、氨苄西林、氯唑西林、头孢呋辛、头孢他啶耐药；对红霉素、庆大霉素、链霉素、四环素、环丙沙星和氧氟沙星有低至中度敏感性；对头孢曲松有中度敏感性，对亚胺培南有高敏感性。急性和慢性伤口感染的革兰氏阳性分离株之间的抗生素耐药模式存在显著差异，但急性和慢性伤口革兰氏阴性分离株之间没有差异。
大多数微生物分离株，尤其是革兰氏阴性分离株，对常用抗生素表现出低敏感性，对较少使用的新型抗生素表现出中度至高度敏感性。
