Shakthi R

Abstract

Introduction: Pyogenic wound infections are the one of the leading cause of morbidity and mortality worldwide. Some of the common etiological agents responsible are Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Klebsiella app., Proteus spp., Pseudomonas spp., and Acinetobacter spp. The antimicrobial resistance has become a global challenge and the resistant pathogen poses a grave threat to the public health worldwide. Pyogenic bacteria producing biofilm has a potential to cause significant mortality and morbidity in human. Aim: The present study was carried out to determine the bacteriological spectrum of wound infections and their antibiogram to commonly used antibiotics and to detect the biofilm production by the isolates.  Materials and Methods: This cross sectional study was carried out in the department of Microbiology, Adichunchanagiri institute of Medical sciences from September 2016 to August 2017. Two hundred and forty samples from various wounds were collected and processed as per standard procedures and biofilm production was detected by Congo red agar method. Results: Out of 240 pus isolates, Staphylococcus species were the most commonly isolated (48.85%) followed by Pseudomonas species (11.7%). Biofilm was produced by 49.2% isolates .Majority of Gram negative bacilli were susceptible to Colistin (100%) followed by Tigecycline (Biofilm producers 75%, biofilm non producers 66.7%).All Gram positive isolates were susceptible to Vancomycin and Teicoplanin (100%) followed by Linezolid (biofilm producer 98.8%, biofilm non producer 97.8%) . Conclusion: Routine surveillance for wound infections along with early identification and adopting efficient control protocol against biofilm forming organism plays an important role in the prevention of the most serious infections. Keywords: Antibiotic resistance, Biofilm, Congo red agar, Wound infection

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Abstract

Background: Methicillin-resistant S.aureus (MRSA) is one of the major causes of healthcare associated infections with significant morbidity and mortality. Health care workers act as a carrier in spread of MRSA in hospitals. Use of Mupirocin to eradicate the carrier state is the need of the hour. Aim: This study was undertaken to assess the prevalence of MRSA colonization among health care workers with varying degree of exposure to hospital environment and to know the susceptibility of Mupirocin to MRSA. Materials and Methods: Swabs were collected from anterior nares and finger web spaces of 100 health care workers (HCWs). The specimens were processed and colonies of S.aures were identified by standard methods. The strains of MRSA were identified by using Cefoxitin (30g) disk on Muller Hinton agar. The MRSA isolates were then tested for Mupirocin susceptibility. Results: In the present study, 100 nasal and inter digital spaces swabs yielded 15 and 10 MRSA strains respectively. Among the 100 HCWs screened, the majority of MRSA colonization was seen in HCWs with a history of exposure to hospital environment for around 5-10 years or more. All 30 S.aureus with 15 MRSA strains isolated was sensitive to both 5?g and 200?g Mupirocin disc by Kirby-Bauer disc diffusion method. Conclusion: The high rate of Nasal MRSA carriage among health care workers is alarming. HCWs with long duration of exposure to hospital environment were more colonized with MRSA. More awareness and training sessions on the importance of MRSA and hand hygiene measures to be implemented to prevent MRSA transmission from HCWs to vulnerable patients. We suggest that MRSA screening should be performed for all HCWs and detection of susceptibility of Mupirocin will result in appropriate use of this antibiotic in decolonization. Keywords: Methicillin resistant Staphylococcus aureus, Health care workers, Colonization, Hand hygiene, Mupirocin.

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