Antimicrobial Susceptibility In Surgical Site Infections After Abdominal Surgery At Kenyatta National Hospital Kenya

Abstract

Background Six (6) month cross-sectional study done at KNH surgical wards on SSI related factors, antimicrobial profile and antibiotic susceptibility testing. The mostly cultured organism is E. coli at 38.9% this is followed at a distant by klebsiella pneumonia and Acinetobacter baumabii at 9.3% each. Mono-microbial SSI accounted for 93.5 % while poly-microbial represented 6.5% of SSIs. E. coli is 100% resistance to penicillin and also high resistance (over 80%) to cephalosporin. There is also more than 50% resistance to cephalosporin. It is highly sensitive to meropenem and the aminoglycosides (over 80%). Determining the causative organisms in surgical site infections and the antibiotic sensitivity and resistance patterns helps to guide clinicians on the choice of antibiotics to be initiated. The knowledge of the prevalent organisms and the drug susceptibility helps in cases where empirical treatment has to be initiated before culture is done. Objective To determine the antimicrobial susceptibility pattern of bacterial isolates from surgical site infections after laparotomy in KNH. Methodology This was a prospective analytical study conducted at the general surgical wards in Kenyatta National Hospital on post laparotomy patients with surgical site infections. Ethical approval from the KNH/UON Ethics and Research Review Committee was sought. Assent and Informed Consent was sought from eligible patients then a data sheet filled from the patients file while assent was got from the parents/guardians of the minors. 2 Pus swab and pus was collected and taken to the microbiology lab in Kenyatta National Hospital followed by data entry after receiving the results. The data was analyzed using SPSS version 22 and presented in tables, pie charts and association analysed using chi-square. Significance of study With development of antibiotic resistance and emergence of multi drug resistance strains of microbes, focused management of surgical site infections is highly advocated. This helps in shorter hospital stay, less cost burden and also helps avoid emergence of drug resistant strains by avoiding misuse of antibiotics