Microbial Spectrum and Antibiogram of Non-surgical Wounds in Children in a Rural Setting in Nigeria
Keywords:
Bakassi, Children, Infection, Non-surgical wounds, Susceptibility pattern.Abstract
The aim of this study was to determine the microbial spectrum and susceptibility pattern of non-surgical wound infections in children in a rural setting in our environment. This study was a cross sectional study of children aged 0 to 15 years in Bakassi, Nigeria. The children were screened for non-surgical wounds using an interviewer administered semi-structured questionnaire. Identified wounds were evaluated clinically for signs of infection and specimens were collected and cultured using standard microbiologic techniques. Susceptibility test was performed on all the isolated Micro-organisms. Data were collected and analysed using SPSS version 20 for windows. Sixty four wound infections out of a total of 115 wounds giving an infection rate of 55.7% were encountered. Of 64 wound cultures, 46.9% (30/64,) yielded mono-microbial growth, while poly-microbial growth of two and three microorganisms were obtained in 46.9% (30/64) and 1.6% (1/64) specimens respectively.
A total of 92 organisms were isolated belonging to seven different species. Staphylococcus aureus (n= 57/92, 62.0%) and Streptococcus pyogenes (n = 30/92, 32.6%) were the predominant pathogens isolated. High rate of community acquired Methicillin Resistant Staphylococcus aureus (MRSA) (38/57, 66.7%) was observed. The microbial spectrum of non-surgical wounds of children in rural communities is wide. The high rate of antimicrobial resistance particularly MRSA and high predominance of S. pyogenes are potential sources of dire consequence in management and long term morbidity.
References
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[2] Roghmann MC, Siddiqui A, Plasance K, Standiford H (2001). MRSA colonization and the risk of MRSA bacteraemia in hospitalized patients with chronic ulcers. Journal of Hospital Infection vol 47(2): 98-103.
[3] Coleman DJ (2000). Wounds, tissue repair, and scars. In: Russell RCG, Williams NS, Bulstrode CJK (eds). Bailey & Love’s Short Practice of Surgery 23rd ed. Arnold London pp 29-39.
[4] Bowler PG, Duerden BI, Armstrong DG (2001). Wound microbiology and associated approaches to wound management. Clin Microbiol Rev vol 14 (2) 244-269.
[5] Heggers JP (1998). Defining infection in chronic wounds: does it matter? J Wound Care vol 7: 389-392.
[6] Heggers JP, Robson MC, Donovan ET (1969). Quantitative assessment of bacterial contamination of open wounds by a slide technique. Trans R Soc Trop Med Hyg vol 63:532-534.
[7] O’Toole RD, Drew WL, Dahlgren BJ, Beaty HN (1970). An outbreak of Methicillin – resistant Staphylococcus aureus infection. Observations in hospital and nursing home. JAMA vol 213(2): 257 – 263.
[8] Otter JA, French GL (2011). Community-associated Methicillin - resistant Staphylococcus aureus strains as a cause of healthcare associated infection. Journal of Hospital Infection vol 14 (7): 670-676.
[9] Makanjuola OB, Olowe OA, Adeyankinnu AF (2013). Bacterial agents of surgical site infections in South Western Nigeria. Am J Biomed Sci vol 5 (4): 217-225.
[10] Emele FE, Izomoh MI, Alufohai E (1999). Microorganism associated with wound infection in Ekpoma, Nigeria. West Afr J Med vol 18(2): 97-100.
[11] Chaudhary P, Shakya C, Pokhrel SR, Karki S, Shrestha B, Timalsina B (2015). Prospective study on bacterial isolates with their antibiotic susceptibility pattern form pus (wound) sample in Kathmandu Model hospital. International Journal of Medicine & Biomedical Sciences vol 1 (1): 15-22.
[12] Azene MK, Beyene BA (2011). Bacteriology and antibiogram of pathogens from wound infections at Dessie Laboratory, North East Ethiopia. Tanzania Journal of Health Research vol 13 (4). DOI: http://dx.doi.org/10.4314/thrb.v13i4.2
[13] Okesola AO, Kehinde AO (2008). Bacteriology of non-surgical wound infections in Ibadan, Nigeria. Afr. J Med Sci vol 37 (3): 261-264.
[14] Noroozi H. Kazemi A, Fadaee R, Alavi S. Mohammadzadeh M (2010). Microbiologic assessment of non-surgical traumatic wound infections and surgical site infections in hospitalised patients. Iranian Journal of Clinical Infectious Disease vol 5 (2): 80-83.
[15] Levine NS, Lindberg RB, Mason Ad Jr, Pruitt BA Jr (1976). The quantitative swab culture and smears: a quick simple method for determining the number of viable aerobic bacteria on open wounds. J Trauma vol 16 (2) 89-94.
[16] Winn WC, Allen SD, Janda M, Koneman EW, Procop GW, Schreckenberger PC, Woods GL (1997). Koneman’s Color Atlas and Txtbook of of Diagnostic Microbiology 6th Ed. Lippincot Williams and Wilkins, Philadelphia, USA.
[17] Clinical and Laboratory Standards Institute (CLSI) (2012). Performance standards for antimicrobial susceptibility testing: twenty-second informational supplement. CLSI document MI00-S22. Wayne, PA: Clinical and Laboratory Standard Institute.
[18] Akinkunmi EO, Adesunkanmi AR, Lamikanra A (2014). Pattern of pathogens from surgical wound infections in a Nigerian hospital and their antimicrobial susceptibility profiles. African Health Sciences vol 14 (4): 802-809.
[19] Iregbu KC, Uwaezuoke NS, NwajiobiPrincewill IP, Eze SO, Medugu N, Shettima S et al (2013). A profile of wound infections in National Hospital Abuja. Afr J Clin Exper Microbiol vol 14 (3): 160-163.
[20] Dow G, Browne A, Sibbald RG (1999). Infection in chronic wounds: controversies in diagnosis and treatment. Ostomy/ Wound Manage vol 45: 23-40.
[21] Davies CE, Hill KE, Newcombe RG, Stephens P, Wilson MJ, Harding KG et al (2007). A prospective study of the microbiology of chronic venous leg ulcers to re-evaluate the clinical predictive value of tissue biopsies and swabs. Wound Repair Regen vol 15 (1) 17-22.
[22] Patterson MJ (1996). Streptococcus. In: Baron S, Albrecht T, Castro G, Couch RB, Davis CP, Dianzani F et al (eds). Medical Microbiology 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston: Available from: http://www.ncbi.n1m.nih.gov/books/NBK 7627.
[23] Cole JN, Barnett TC, Nizet V, Walker MJ (2011). Molecular insight into invasive group A Streptococcal disease. Nature Reviews Microbiol vol 9: 724-736.
[24] Uwaezuoke JC, Aririatu LE (2004). A survey of antibiotic resistant Staphylococcus aureus strains from clinical sources in Owerri. J Appl Sci Environ Mgt vol 8 (1): 67-69.
[25] Usang UE, Sowande OA, Adejuyigbe O, Bakare TIB, Ademuyiwa AO (2008). The role of preoperative antibiotics in the prevention of wound infection after day case surgery for inguinal hernia in children in Ile Ife, Nigeria. Pediatr Surg Int vol 24 (10): 1181-1185.
[26] Sani RA, Garba SA, Oyewole OA, Ibrahim A (2012). Antibiotic resistance profile of Gram- positive bacteria isolated from wound infections in Minna, Bida, Kantagora and Suleja areas of Niger State. Journal of Health Sciences vol 2 (3): 19-22.
[27] Perterson DL (2002). Looking for risk Factors for acquisition of antibiotic resistance: A 21st century approach. Clin Infect Dis vol 34: 1564-1567.
[28] Shittu S, Kehinde AO, Ademola SA, Okesola AO, Oluwatosin OM, Bakare RA (2004). Pattern of bacterial pathogens in burn wound infections in Ibadan, Nigeria. Annal Burns Fire Disasters vol 17 (1): 12-15.
[29] Centers for Disease Control and Prevention (2001). Methicillin – Resistant Staphylococcus aureus skin or soft tissue infections in a state prison – Mississippi, 2000. MMWR Morb Mortal Wkly Rep vol 50: 919-922.
[30] Centers for Disease Control and Prevention (2003). Outbreak of community associated Methicillin-Resistant Staphylococcus aureus skin infections – Los Angeles County, California 2002-2003. MMWR Morb Mortal Wkly Rep vol 52:88.
[31] Hidron AI, Kourbatova EV, Sue Halvosa J, Terrell BJ, McDougal LK, Tenover FC (20050. Risk factors for colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) in Patients Admitted to an Urban Hospital: Emergence of Community-Associated MRSA Nasal Carriage. Clin Infect Dis vol 41:159–166.
[32] Lynskey NN, Lawrenson RA, Sriskandan S (2011). New understanding in Streptococcus pyogenes. Curr Opin Infect Dis vol 24: 196-202.
[33] Carlo G, Nobilio L, Milandri M, Moro ML (2006). Macrolide Prescriptions and erythromycin resistance of Streptococcus pyogenes. Clin infect Dis vol 42: 1153-1156.
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Published
2016-09-28
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E Usang, U., A Ochang, E., W Inyang, A., O Otei, O., A Eyo, O., & E Ekanem, E. (2016). Microbial Spectrum and Antibiogram of Non-surgical Wounds in Children in a Rural Setting in Nigeria. American Scientific Research Journal for Engineering, Technology, and Sciences, 25(1), 289–300. Retrieved from https://asrjetsjournal.org/index.php/American_Scientific_Journal/article/view/2067
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