Antibiotic Sensitivity in Post Cesarean Surgical Site Infection at a Tertiary Care Centre in Eastern Nepal

Abstract

Introduction: Post cesarean surgical site infection (SSI) is one of the common complications diagnosed in 2.5%-16% of the cases and is associated with significant increase in maternal morbidity, hospital stay, costs, and psychological stress to the new parents. This study was designed to study the incidence of SSI and the antimicrobial resistance pattern in our hospital.
 
 Methods: This was a prospective observational study conducted from July 2015 to December 2015, in which all patients who were admitted with post cesarean SSI or developed SSI during their stay were included. Wound specimens were collected and susceptibility testing was carried out using disc diffusion technique.
 
 Results: The incidence of post cesarean SSI was 6.07% (47/774). Out of the 47 patients who had SSI, 35 (74.75%) had positive swab culture. The most important organism isolated was Staphylococcus aureus (82.85%) out of which 17 (58.62%) were MRSA strain. The resistance of Staphylococcus to penicillin was 84.6% whereas amikacin was found to be highly sensitive (>96%). Among the MRSA strain, resistance to ciprofloxacin, which is the currently used drug for prophylaxis, was 94%. Resistance to penicillins, cephalosporins, and clavulanate was also high. Resistance to vancomycin was also high (53%). Amikacin and chloramphenicol were found to be highly sensitive (94% and 90% respectively) in the MRSA group.
 
 Conclusion: MRSA is the leading cause of post cesarean SSI and is a matter of great concern. Amikacin and chloramphenicol were found to be highly sensitive in this group but unlike other studies, resistance of vancomycin was showing an increasing trend.

Prevalence and Antimicrobial Susceptibility Profile of Bacterial Isolates from Infected Caesarean Sites in Three Federal Capital Territory Hospitals, Abuja Nigeria

“…However, in contrast to our findings, they recorded 50.7% susceptibility to tetracycline by S. aureus in their report on antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia. Also, in contrast to our findings of 83.3% Staphylococcus aureus susceptibility to ciprofloxacin, Chhetry et al [20], in Nepal reported 86.2% Staphylococcus aureus resistance of ciprofloxacin.…”

“…However their findings of 100% resistance of gentamycin by Klebsiella spp varies with our report of 75% resistance. Also in a justification of our findings of very high resistance to commonly used antibiotics by gram negative organisms, Chhetry et al [20], in Nepal reported 80% ciprofloxacin and erythromycin resistance and 100% cotrimoxazole resistance by E. coli while a 100% ciprofloxacin and erythromycin resistance by Klebsiella spp was also recorded.…”

Post-Caesarean Wound Infections: Incidence, Bacterial Profiles, Antimicrobial Susceptibility Patterns and Associated Factors in Public Hospitals, Southern Ethiopia

“…The overall rate of culture-con rmed post-caesarean wound infections observed in the current study was 85.78% and is consistent with the reports from Kuwait (75.7%) [23], Nepal (74.75%) [24] and Uganda (85%) [25]. However, it was slightly higher than the results of earlier studies reported from Nigeria (92.2%) [19] and Cameroon (96%) [26].…”

Prevalence, Risk Factors and Microbial Profile of Surgical Site Infection after Cesarean Section in a Tertiary Care Center in Western India

“…We have observed very low resistance of imipenem and netilmicin this might be due to limited exposure of these antibiotics because of their expensiveness. Among gram-positive isolates (Staphylococcus aureus & coagulase negative staph) penicillin group of antibiotics was shown high resistance in the current study accordance to Walelign et al 34 Very high incidence of MRSA (76.8%) reported in our study compatible to Rijal et al 35 showed 75.5% MRSA contrary to that Chhetri M. et al (36) reported 58.6% MRSA on their study. Overall Imipenem was the most sensitive and amoxicillin/ clavulanate was the most resistant antibiotic in our study similar findings were observed by Ezat H et al 37…”