BACTERIA ISOLATED FROM WOUNDS AND THEIR ANTIBIOTIC PROFILES

ABSTRACT

Bacterial isolates from wounds and their antibiotic profiles were investigated. The wound specimens were cultured on different media such as Nutrient agar, MacConkey agar, Mannitol salt agar for isolation of the bacteria associated with the wounds. The isolates were identified following different biochemical test such as catalase, coagulase, oxidase. A total of 45 bacteria were isolated from the wound specimen. The isolates include Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Streptococcus, Staphylococcus epidermidis. Staphylococcus aureus was the most commonest pathogen (31.1%), followed by Escherichia coli (24.4), Pseudomonas aeruginosa (13.3%), Proteus species (13.3%), Streptococcus species (11.1%) and Staphylococcus epidermidis (6.7%). Most isolates showed high susceptibility to levofloxacin, ciprofloxacin and gentamycin and rifampicin while amoxil and norfloxacin, chloramphenicol recorded high resistance to the isolates. Despite the rapid improvement in medical care, wound infection still represent a serious problem for patients, with many bacteria developed difference degrees of resistance to most known antibiotics.

TABLE OF CONTENTS

Title page                                                                                                                                i          

Certification                                                                                                                           ii

Dedication                                                                                                                              iii

Acknowledgements                                                                                                                iv

Table of Contents                                                                                                                   v

List of Tables                                                                                                                          vii

Abstract                                                                                                                                   viii

CHAPTER ONE

1.0           INTRODUCTION                                                                                                    1

1.1           Aim and Objectives                                                                                                    2

1.2           Significance                                                                                                                2

CHAPTER TWO

2.0       LITERATURE REVIEW

2.1       Causes and Types of Wound Infections                                                                     5

2.1.1    Surgical Wound Infection                                                                                          6

2.1.2    Acute Soft Tissue Infections                                                                                      8

2.1.3    Bite Wound Infections                                                                                                8

2.1.4    Burn and Infections                                                                                                    9

2.1.5    Diabetic Foot Ulcer Infections                                                                                   9

2.1.6    Leg and Decubitus (Pressure) Ulcer Infections                                                          10

2.2       Bacterial Species Present in Wound                                                                           10

2.2       Diagnosis of Wound Sepsis                                                                                        11

2.3       Management of Wound Sepsis                                                                                   11

CHAPTER THREE

3.0       MATERIALS AND METHODS

3.1       Sample Collections                                                                                                     14

3.2       Media Preparation                                                                                                      14

3.3       Isolation Methods                                                                                                       14

3.4       Characterization and Identification of Bacterial Isolates                                           15

3.4.1    Gram Staining Technique                                                                                           15

3.4.2    Motility Test                                                                                                               16

3.4.3    Biochemical Test                                                                                                        16

3.4.3.1 Catalase Test                                                                                                               16

3.4.3.2 Citrate Test                                                                                                                 16

3.4.3.3 Coagulase Test                                                                                                            17

3.4.3.4 Indole Test                                                                                                                  18

3.4.3.5 Oxidase Test                                                                                                               18

3.4.3.6 Methyl-Red Test                                                                                                         19

3.4.3.7 Voges-Proskaver Test                                                                                                 19

3.5       Antibiotic Sensitivity Test                                                                                          20

CHAPTER FOUR

4.0       RESULTS AND DISCUSSION 21                                                                          21

CHAPTER FIVE

5.0       DISCUSSION, CONCLUSION AND RECOMMENDATION

5.1       Discussion                                                                                                                   26

5.2       Conclusion                                                                                                                  27

5.3       Recommendation                                                                                                        28

            References                                                                                                                 

LIST OF TABLES

Table                         Title                                              Page

CHAPTER ONE

            1.0    INTRODUCTION

Wound is any interruption by violence or by surgery, in the continuity of the external surfaces by the body or the surface of any internal or pain. Wound infections are one of the most common hospital acquired infections and are an important cause of morbidity and account for 70-80% mortality (Gottrup et.al., 2005; Wilson et.al., 2004). Wound infections have been regarded as the most nosocomial infections and are associated with increased morbidity and mortality (Dionigi et al., 2001).

Infections in a wound delays healing causes wound breakdown prolonged hospital stay. Increased trauma care and treatment costs (Bowler et al., 2001; Alexander 1994). Bacteriological studies have also shown that wound infections is universal and that the types of bacteria vary with geographical locations, bacteria on the skin, clothing at the site of wound, time between wound and examination (Trilla, 1994). The control of would infections has become more challenging due to widespread bacterial resistance to antibiotics and due to an increasing incidence of infectious caused methicillin resistance Staphylococcus aureus (MRSA) and polymicrobic flora.

In developing countries wound infections are recognized as a prominent route of bacterial infections. Many bacterial agents are known to cause wound infections. (Yah et al., 2004). Isolates that have been incriminated in cases of wound infection include Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, Klebsiella aerogenes Escherichia coli, Staphylococcus epidermidis, Streptococcus pyogenes and Streptococcus faecalis Candida albicans and Candida tropical have also been implicated as etiological agents (Amelski et al., 2002; Enweani et al., 2003; Kaplan et al., 2003; Isibor et al., 2008).

The knowledge of the causative agents of wound infections will be therefore helpful in the selection of antimicrobial therapy.

            1.3           AIM AND OBJECTIVES

The aim of this study is to isolate identity and ascertain the antibiotic profile of bacteria associated with wound sepsis the general objectives of this study was to

1.     Identify the bacteria that cause wound infection

2.     Determine the percentage occurrence of bacterial isolates

3.     Determine the antimicrobial sensitivity patterns of the isolated bacteria.

1.2       SIGNIFICANCE

The findings of this research project help in choosing appropriate antibiotics by considering the sensitivity patterns that were observed hence, appropriate management of the infected wounds. This would result in a cost effect therapy for the patient and reduce financial burden of hospitalization.

            1.4           LIMITATIONS

Wound sepsis are caused by a number of microorganisms which included fungi, bacterial and viruses. This study was only able to address wound sepsis caused by bacteria. This study was not able to address the factors that contribute to resistance patterns of the bacteria that were observed. This study was also limited by certain factors which include specimens collection some patients yield for their specimens not to be taken.

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