Infection and Drug Resistance (May 2022)

Bacteriological Profiles, Antimicrobial Susceptibility Patterns, and Associated Factors in Patients Undergoing Orthopedic Surgery with Suspicion of Surgical Site Infection at Arba Minch General Hospital in Southern Ethiopia

  • Alelign D,
  • Tena T,
  • Tadesse D,
  • Tessema M,
  • Seid M,
  • Oumer Y,
  • Aklilu A,
  • Beyene K,
  • Bekele A,
  • Abebe G,
  • Alemu M

Journal volume & issue
Vol. Volume 15
pp. 2427 – 2443

Abstract

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Dagninet Alelign,1 Teshome Tena,2 Dagimawie Tadesse,1 Moges Tessema,2 Mohamed Seid,1 Yisiak Oumer,1 Addis Aklilu,1 Kassaw Beyene,3 Alehegn Bekele,4 Getachew Abebe,4 Mathewos Alemu5 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 4Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 5Department of Public Health, College of Health Sciences, Bonga University, Bonga, EthiopiaCorrespondence: Dagninet Alelign, Tel +251-964-428-118, Email [email protected]: In the thoughts of all orthopedicians, the emergence of drug-resistant and biofilm-forming bacterial infections at orthopedic surgical sites is the most feared problem. Thus, this study aimed to determine the bacteriological profiles, antimicrobial susceptibility patterns, and biofilm forming ability of isolates, as well as factors associated with orthopedic surgical site infections (OSSIs).Methods: An institution-based cross-sectional study was conducted from March 1st, 2021, to February 30th, 2022 at Arba Minch General Hospital. About 245 suspected orthopedic patients with surgical site infection were enrolled and structured questionnaires were used to collect the required information. Wound swabs or pus aspirates were aseptically collected. The frequency and type of bacterial pathogen(s), antimicrobial susceptibility pattern, and biofilm formation were used to determine and characterize the magnitude of OSSIs. SPSS version 25 was used to analyze factors associated with OSSIs.Results: The overall magnitude of symptomatic OSSIs was 29.4% (72/245). External fixation [AOR = 4.761, 95% CI: (1.108– 20.457)], implant use [AOR = 3.470, 95% CI: (1.460– 8.246)], length of time for surgery [AOR = 3.225, 95% CI: (1.545– 6.731)], and post-operative hospitalization [AOR = 4.099, 95% CI: (2.026– 8.293)] were all statistically significant. Staphylococcus aureus was the most frequently isolated bacteria, accounting for 76%. Methicillin-resistant was observed in 57.9% and 40% of isolated S. aureus (MRSA) and coagulase-negative staphylococci (CoNS), respectively. One-third of the isolated E. faecium was vancomycin-resistant (VRE). Overall, 67.1% (51/76) of isolates were multidrug-resistant (MDR). About 27.6% (21/76) of isolates were found to be strong biofilm producers.Conclusion: OSSIs were shown to be caused by a significant number of drug-resistant and biofilm-producing bacterial isolates. To mitigate the problem, aseptic surgical practice and conventional wound management, as well as constant observation of antimicrobial resistant patterns, should be followed.Keywords: antimicrobial susceptibility, bacterial pathogen, biofilm, orthopedic surgical site infection, Arba Minch, Ethiopia

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