Drug resistance profile in postbiliary and gastrointestinal surgical-site infection cases from a tertiary care hospital.

Abstract

In the developing world, surgical-site infection (SSI)-associated pathogens are becoming more drug resistant implicating higher morbidity and management cost. Here, we tried to analyze the drug resistance pattern in our SSI-related isolates. Over 2 years, 191 clinically diagnosed SSIs (postbiliary tract and postgastrointestinal surgery) were included, and wound swabs were processed by conventional aerobic and anaerobic culture. Antibiotic minimum inhibitory concentration (MIC) was determined by the Epsilometer testing. Multidrug-resistant phenotypes were detected as per guidelines. The rate of SSI was 5.3% with Klebsiella, Staphylococcus, and Pseudomonas, growing predominantly, and no anaerobe detectable. About 19.4% of Staphylococcus aureus were methicillin-resistant S. aureus, and one-third of them had raised macrolide MIC. About 58.2% of Enterobacteriaceae isolates were extended-spectrum beta-lactamase producers. Isolates with raised meropenem MIC were observed. Antibiotic-resistant level in SSI cases is alarmingly high, and in susceptible strains, MIC is approaching the resistant level. Urgent corrective action is an emergency necessity.