Gyilbagr Fredrick, Walana Williams, Buunaaim Alexis D B, Vicar Ezekiel Kofi, Ankrah Jacob Nii Otinkorang, Frimpong Emmanuel Antwi Boasiako, Alhassan Rukaya Baanah, Baako Ibrahim Sibdow, Boakye Alahaman Nana, Akwetey Samuel Addo, Karikari Akosua Bonsu, Helegbe Gideon Kofi, Tabiri Stephen
Department of Clinical Microbiology, University for Development Studies, Tamale, Ghana.
Department of Laboratory Service, Tamale Teaching Hospital, Tamale, Ghana.
Int J Microbiol. 2025 Aug 7;2025:9949633. doi: 10.1155/ijm/9949633. eCollection 2025.
Surgical site infections (SSIs) remain a critical challenge globally and are aggravated by rising antimicrobial resistance (AMR). Here, we evaluated the bacterial profile, AMR patterns, and ESL characterization of isolates from patients diagnosed with SSI after trauma orthopedic surgery. This prospective study was carried out at Tamale Teaching Hospital from September 2023 to May 2024. Patients were asked to provide demographic data. Samples were also collected from patients suspected of SSI and cultured for bacterial isolation, identification, and AMR characterization. In all, 210 patients were recruited for this study, and 14 (6.7%) out of 19 suspected cases developed SSI. Of 19 specimens, 14 (73.68%) were culture-positive, yielding 22 isolates. Monomicrobial growth were 7 (50.0%) and polymicrobial growth 7 (50.0%). Among the isolates, 3 (13.64%) were Gram-positive and 19 (86.36%) were Gram-negative bacilli. (5, 22.73%) were the most common isolates, followed by spp. (4, 18.18%). ESL-positive isolates were 3 (23.08%). PCR confirmed the expression of CTXM and SHV genes by two spp. and the CTXM gene by . Gram-negative bacteria, particularly , were the dominant isolates from surgical sites after trauma orthopedic surgery. Among the Gram-positives, was dominant. Among the Enterobacterales isolates, ESBL production was detected in three cases (23.08%), with two spp. harboring CTXM and SHV resistance genes, and CTXM in one . The current study has revealed varied resistant patterns of AMR, with CTXM and SHV as common ESL genes among the isolates. The clinical identification of CTX-M and SHV genes could guide clinicians to consider alternative treatments to optimize therapeutic outcomes and limit the spread of resistant pathogens.
手术部位感染（SSIs）在全球范围内仍然是一个严峻的挑战，并且随着抗菌药物耐药性（AMR）的上升而加剧。在此，我们评估了创伤骨科手术后被诊断为SSI的患者分离株的细菌谱、AMR模式和超广谱β-内酰胺酶（ESBL）特征。这项前瞻性研究于2023年9月至2024年5月在塔马利教学医院进行。患者被要求提供人口统计学数据。还从疑似SSI的患者中采集样本，进行细菌分离、鉴定和AMR特征分析。总共招募了210名患者参与本研究，19例疑似病例中有14例（6.7%）发生了SSI。在19份标本中，14份（73.68%）培养阳性，分离出22株菌株。单一微生物生长的有7株（50.0%），多微生物生长的有7株（50.0%）。在分离株中，3株（13.64%）为革兰氏阳性菌，19株（86.36%）为革兰氏阴性杆菌。大肠埃希菌（5株，22.73%）是最常见的分离株，其次是肺炎克雷伯菌（4株，18.18%）。产ESBL的分离株有3株（23.08%）。PCR证实了两株肺炎克雷伯菌表达了CTX-M和SHV基因，一株大肠埃希菌表达了CTX-M基因。革兰氏阴性菌，尤其是大肠埃希菌，是创伤骨科手术后手术部位的主要分离株。在革兰氏阳性菌中，金黄色葡萄球菌占主导。在肠杆菌科分离株中，检测到3例（23.08%）产ESBL，其中两株肺炎克雷伯菌携带CTX-M和SHV耐药基因，一株大肠埃希菌携带CTX-M基因。目前的研究揭示了AMR的多种耐药模式，CTX-M和SHV是分离株中常见的ESBL基因。CTX-M和SHV基因的临床鉴定可以指导临床医生考虑替代治疗方法，以优化治疗效果并限制耐药病原体的传播。
