Sherchan Jatan Bahadur, Gurung Pranita
Department of Microbiology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
Department of Pathology, Kathmandu Medical College, Kathmandu, Nepal.
J Nepal Health Res Counc. 2019 Jan 28;16(41):446-451.
Wound infection with multidrug resistant bacteria along with risk factors is a major burden and challenge to the health care persons. This study focuses on antibiotic susceptibility pattern of bacterial isolates and risk factors of patients with infected wounds.
This was a cross-sectional study conducted between November 2017 to June 2018 in Kathmandu University Hospital. Pus sample and wound swabs collected from patients during the study period were included. All microbiological processing were done following standard guidelines and patient's information was collected following ethical guidelines.
Total number of patients observed for wound infection was 2,763. Pathogenic bacteria were detected in 252(9.12%) samples. 167(66.27%) were multidrug resistant. 118(46.82%) had risk factors. Among risk factors 14 had malignancy, 12 had diabetes, 32 were above age 60 without other risk factors, 45 received prior antibiotics and had critical illness and 15 were renal failure patients. Multidrug resistant bacteria was detected more among patients with risk factors 101(85.59%) in comparison to patients without risk factor 66(49.25%). When p value was calculated it was found significant. (p=<0.05).
Significant amount of multidrug resistant bacteria were found in wounds of patients with risk factors. Prevention of wound infection by taking care of postoperative wounds, controlling and treating the risk factors, avoiding misuse of antibiotics and early microbiological analysis of infected wound might help to reduce the burden in healthcare centers.
多重耐药菌引起的伤口感染以及危险因素对医护人员来说是一项重大负担和挑战。本研究聚焦于细菌分离株的抗生素敏感性模式以及伤口感染患者的危险因素。
这是一项于2017年11月至2018年6月在加德满都大学医院开展的横断面研究。纳入了研究期间从患者身上采集的脓液样本和伤口拭子。所有微生物学处理均按照标准指南进行，患者信息按照伦理准则收集。
观察到的伤口感染患者总数为2763例。在252份（9.12%）样本中检测到病原菌。167份（66.27%）为多重耐药菌。118例（46.82%）有危险因素。在危险因素中，14例患有恶性肿瘤，12例患有糖尿病，32例年龄在60岁以上且无其他危险因素，45例曾接受过抗生素治疗且患有危重症，15例为肾衰竭患者。与无危险因素的患者66例（49.25%）相比，有危险因素的患者中检测到多重耐药菌的更多，为101例（85.59%）。计算p值时发现具有显著性（p≤0.05）。
在有危险因素的患者伤口中发现了大量多重耐药菌。通过护理术后伤口、控制和治疗危险因素、避免滥用抗生素以及对感染伤口进行早期微生物学分析来预防伤口感染，可能有助于减轻医疗中心的负担。
