AEROBIC BACTERIA ISOLATES, DRUG SUSCEPTIBILITY PATTERN AND ASSOCIATED FACTORS AMONG CLINICALLY SUSPECTED PATIENTS ADMITTED FOR WOUND INFECTION AT DIL-CHORA REFERRAL HOSPITAL, DIRE DAWA, EASTERN ETHIOPIA

Abstract

A wound is a breach in the skin and the exposure of subcutaneous tissue following loss of skin integrity providing moist, warm and nutritive environment that is conducive to microbial colonization and proliferation. Wound can be infected by a variety of microorganisms ranging from bacteria to fungi and parasites as well as virus. The aim of this study is to identify bacteria isolate, their drug susceptibility pattern and associated factors among clinically suspected patients admitted for wound infection at Dil-Chora Referral Hospital from March 15/2016 to June 14/2016. A hospital based cross-sectional study was used among a total of 188 patients using purposive sampling techniques. Data on socio-demographic and clinical information and other factors were collected using a pretested structured questionnaire. Wound swab/pus discharge were collected and inoculated on Blood and Macckonckey agar. Biochemical tests and Antimicrobial susceptibility test was performed following standard disk diffusion technique of modified Kirby-Bauer method. Data were analysed using Statistical package for social science (SPSS) version 16 software. The overall magnitude of bacteria isolated from wound infection in this study was 89.4%. Staphylococcus aureus was the predominant organisms (32.9%) followed by Proteus species (28.6), CONS (13.1%), P. aeruginosa (8.5%), Klebsiella species (6.1%), E. coli (4.2%), Citrobacter (3.8%) and Providencia (2.8%). Gram positive bacteria showed high frequency of resistance to ampicillin, penicillin and erythromycin. Gram negative bacteria showed high frequency of resistance to ampicillin, chloramphenicol, cotrimoxazole, ceftriaxone and doxycycline. The overall Multi drug resistance rate was 85%. Of the following risk factors: Sex, Type of specimens and Type of ward was identified as a risk factor for wound infection. The magnitude of bacteria isolated from wound infection in Dil-Chora Referral Hospital was found to be high. Drug resistance was seen in 207/213(97.2%) of the isolated bacteria. Such widespread resistance to antimicrobial agents is something serious because a few treatment options remain for patients with wound infection. Amikacin, Gentamicin and Vancomycin are best antibiotics for treatment of bacterial wound infection at Dil-Chora Referral Hospital and other nearby health institutions at Dire Dawa.