Antimicrobial susceptibility of bacteria that cause wound sepsis in the paediatric surgical patients at Kenyatta National Hospital

Abstract

Background: Despite improvement in the practice of medicine and attempts to provide aseptic conditions in the surgical wards, the incidence of wound infection is increasing. Management of wound infection remains a challenge in the surgical areas with the increasing resistance to antimicrobials. Local bacterial sensitivity data is therefore an important guide for antibiotic selection. Objective: To determine the aetiology and antimicrobial sensitivity patterns of bacteria that cause wound sepsis in the paediatric surgical wards at the Kenyatta National Hospital. Methodology: A cross- sectional study was carried out on 150 paediatric patients admitted in the surgical wards from mid April 2014 to mid June, 2014. The patients were selected by convenient sampling. Data was abstracted from patient files and specimens from the infected wounds were identified and analyzed for antibiotic susceptibility. Results: The prevalence of wound infection was 82%. Staphylococcus aureus (52.7%) was the most prevalent infective agent followed by Pseudomonas aeruginosa (17.3%). Staphylococcus aureus was the most resistant organism with susceptibility of less than 50% to most drugs. About 50.6% of the Staphylococcus isolates were methicillin resistant. Streptococcus was less resistant with more than 80% susceptibility to all tested drugs except cefuroxime. Escherichia coli were sensitive to ciprofloxacin. All gram negative bacteria were highly sensitive to ciprofloxacin with the following susceptibilities: Pseudomonas aeruginosa (92.3%), Proteus mirabilis (71.4%) and others 100%. Imipenem which is a new and relatively expensive monobactam demonstrated reduced activity with the following susceptibilities: Staphylococcus aureus (38%), Streptococcus (80%) and all the gram negative bacteria (70%). Conclusion: The most common causative agent was Staphylococcus aureus and less than 50% of the isolates were susceptible to all tested antibiotics.