![]() Plates with no growth and with growth were re-incubated for another 18–48 h for isolation of bacteria that require extended incubation (slow growers). They were then observed for bacterial growth. Pus swabs were streaked on Blood Agar (BA) and MacConkey Agar (MCA) plates and incubated aerobically for 18–24 h at 37 ☌. A swab moistened with sterile normal saline was rolled deep in the wounds and inserted immediately into a tube containing Stuart’s transport media for preservation of microbes and then transported to the laboratory. When there were two or more wounds in the same location, separate swabs were used for each wound. Sterile gauze was used to remove excess saline from the wound surface and the pus swabs were collected using sterile swab by swabbing at the middle of the wound. To avoid contaminating the swab with skin flora, pus or necrotic tissue, the wound was thoroughly cleansed with 60–120 mL sterile normal saline prior to taking the sample. Wound swabs were collected from patients with infected diabetic wounds, surgical sites, trauma and other wounds by the research nurse. Data collection Pus swabs collection and culture Chronic wound was differentiated from acute wound if it failed to heal within 4 weeks and showed no sign of improvement within 8 weeks. Patients presenting with at least three of these clinical signs were enrolled in the study. Prior to enrolment in the study, patients were examined by a physician for a suspected or actual wound sepsis using the following criteria ‘cellulitis’, ‘maladour’, ‘pain’, ‘delayed healing’, ‘deterioration in the wound’ or ‘wound breakdown’ and ‘increase in exudate volume’. Patients with Surgical Sites Infections (SSI), infected diabetic wounds, infected wounds due to trauma, and patients with other infected wounds admitted in surgical ward at Kilimanjaro Christian Medical Centre (KCMC) from July 2013 to June 2014 were included in this study. This makes infection of wounds a matter of concern and makes it necessary to study the causative agents of these infections and their antibiogram.Ĭharacteristics of participants and enrolment procedures Infection in a wound delays healing, prolongs hospital stay, increases trauma, poses risk for disarticulation and amputation, increases need for medical care and increases treatment costs. aureus (MRSA) and most bacteria isolated are sensitive to quinolones, aminoglycosides and monobactam. The majority of the isolates from infected wounds are known to be resistant to ampicillin and amoxicillin. Pseudomonas aeruginosa are commonly isolated in infected wounds following surgeries and burns whereas Enterococcus species and Enterobacteriaceae are commonly isolated from wounds in immune-compromised patients and abdominal surgeries. aureus) has been reported to be the most common isolated bacteria from different wound types. Ĭomparing to Gram-negative, Gram-positives bacteria have been reported to be less prevalent causing wound infections. In Tanzania, the death rate due to ESBL producing GNR is as high as 13.9%. About 33% of infections by ESBL producers are deadly. The prevalence of ESBL producing GNR varies across the world from 50 to 80%. ESBL producing Gram-negative rods (GNRs) have spread all over the world. Įxtended spectrum beta-lactamase (ESBL) producing organisms are another type of common bacteria resistant to antibiotics. Inappropriate use of antibiotics increases selection pressure favouring the emergence of pathogenic drug-resistant bacteria which makes the choice of empirical antimicrobial agents more complicated. In hospital practice, 30–50% of antibiotics are prescribed for surgical prophylaxis and 30–90% of these prophylaxes are inappropriate. ĭrug resistance impinges on the quality of patient care through its associated mortality, morbidity and significant economic consequences. ![]() Wound infections increase with the degree of wound contamination, and it is estimated that 50% of wounds contaminated by bacteria become clinically infected. Wound infections have been reported to vary between 3 and 11% in developed countries and estimated to be as high as 40% in developing countries. Bacterial infections of wounds are among the leading causes of morbidity and mortality throughout the world and are regarded as one of the most common nosocomial infections.
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