A STUDY ON BACTERIAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN IN POST SURGICAL WOUND INFECTION IN A TERTIARY CARE CENTRE

OBJECTIVE To study the bacterial profile and antibiotic susceptibility pattern in post surgical wound infections.MATERIALS AND METHODS This study was done in patients with post surgical wound infections.Pus samples were collected from wound discharge using sterile swab and processed by Gram staining and culturing on to appropriate plates.Antibiotic susceptibility testing was done by Disc diffusion method (Kirby Bauer method) on Mueller Hinton Agar . RESULTS Out of 50 samples,54 organisms were isolated. E.coli was the predominant isolate( 29.6 percentage), followed by Pseudomonas aeruginosa ( 22.2 percentage) . E.coli was 31.3 percentage sensitive to Ceftazidime, 43.8 percentage sensitive to Ofloxacin, 93.8 percentage sensitive to Amikacin and were 100 p-ercentage sensitive to Cefoperazone sulbactum and Imipenem . Pseudomonas aeruginosa was 16.7 percentage sensitive to Ceftazidime Ofloxacin,41.7 percentage sensitive to Amikacin,91.7 percentage sensitive to Cefoperazone sulbactum and 100 percentage sensitive to Imipenem.Klebsiella pneumoniae was 66.7 percentage sensitive to Amikacin and Ofloxacin but only 16.7 percentage sensitive to Ceftazidime.It was 100 percentage sensitive to Cefoperazone sulbactam and Imipenem.Staphylococcus aureus was 100 percentage sensitive to Amikacin and 62.5 percentage sensitive to Erythromycin and Cephalexin and 12.5 percentage sensitive to Ciprofloxacin.Staphylococcus epidermidis was 50 percentage sensitive to Amikacin ,Cotrimoxazole,Ciprofloxacin and Tetracycline.Only one Enterococcus faecalis was isolated and it was sensitive to Amikacin, Ciprofloxacin and Penicillin.CONCLUSION High resistance rates has been observed for Cephalosporins and Fluoroquinolones among the Gram negative bacilli in post surgical wound infections.Amikacin ,Cefoperazone sulbactum and Imipenem were found effective in these organisms and they will be effective in formulating the prophylactic therapy for prevention of post surgical wound infection. An Initiative of The Tamil Nadu Dr. M.G.R. Medical University University Journal of Pre and Para Clinical Sciences Keyword :Post operative wound infection,Surgical site infection,Antibitic susceptibility pattern,Prophylactic antibiotic therapy,SSI INTRODUCTION The skin serves as an important barrier to the invasion of infectious agents. When the skin integrity is physically broken as during surgery or accidentally, it becomes contaminated with varying numbers and types of microbial agents leading to local infection. In performing a successful surgical operation, the surgeon must be familiar with the principles and practice of aseptic surgery; which comprise preparation of patient, the operator and the surgical instrument as well as the theatre5 . Despite considerable research on best practices and strides in refining surgical techniques, technological advances and environmental improvement in the operating room [OR] and the use of prophylatic preoperative antibiotics, infection at the surgical site remains the second most common adverse event occurring to hospitalized patients and a major source of morbidity following surgical procedures8,10. In 1992, the US Centers for Disease Control [ CDC ] revised its definition of “wound infection”, creating the definition “Surgical Site Infection” [SSI ] to prevent confusion between the infection of the surgical incision and the infection of a traumatic wound. About 77% of the deaths of surgical patient were related to surgical wound infections9 . A complex interplay between host, microbial and surgical factors ultimately determines the prevention or establishment of a wound infection[Fig- 1] . Wounds are classified into clean wounds, clean contaminated wounds, contaminated wounds and dirty wounds by CDC4 .Most postoperative wound infections are endogenous and are acquired from the skin, mucous membranes, or gastro intestinal tract of the patient7 . Exogenous infections are mainly acquired from the nose or skin flora of the