Bacteria causing community acquired superficial skin infections in tertiary care hospitals and their antibiotics susceptibility patterns
Keywords:
Community acquired superficial skin infections, staphylococcus aureus, methicillin resistant staphylococcus aureus (MRSA), pseudomonas aeruginosa, vancomycinAbstract
Objective To find out the antibiotic susceptibility pattern of different types of bacteria causing community acquired superficial skin infections and to find the frequency of MRSA in community-acquired primary pyodermas in outpatients visiting the tertiary care hospitals. Methods Following informed consent, swab samples were collected from infected skin patches and microbiologic examination done. The collected samples were cultured, followed by Gram stain and different bacterial isolates were then identified by conventional biochemical tests, as per Clinical Laboratory Standard Institute (CLSI) guidelines, the modified Kirby Bauer disk diffusion method was used to test the antibiotic sensitivity with standard antibiotic discs. MRSA were detected by using cefoxitin disc and by determining minimum inhibitory concentrations (MIC) of oxacillin. MRSA isolates were further confirmed by targeting mecA gene. Results Overall 205 patients were analyzed with age in range of 1 month to 60 years (with a median age of 12). The ratio between male and female ratio was 1.6:1. A total of 54 (26.3%) cases that displayed no signs of growth. Growth was observed in 151 (73.65%) cases, 142 (94%) cases showed growth for single bacteria while multiple growth was observed in 9 (6%) cases so a total of 158 bacterial isolates were obtained and processed in this study. Among 205 cases, 56 (27.3%) were of folliculitis, 52 (25.36%) of cellulitis, 44 (21.46%) of furunculosis, 42 (20.48%) of impetigo and11 (5.36%) were of ecthyma. Among 151 positive cases Staphylococcus aureus was found in 50 (33.11%) cases, followed by Pseudomonas aeruginosa 32 (21.19%), Escherichia coli 31(20.52%), Streptococci 24 (15.89%) and Enterobacter spp. 21 (13.90%). S. aureus was found to be ampicillin- and amoxicillin-resistant in all cases and 20 (40%) were discovered to be Cefoxitin resistant (MRSA). Conclusion The antibiotic choice for S. aureus should be Clindamycin, Doxycycline, and Linezolid. In case of MRSA, Fusidic acid and Vancomycin should be recommended. Gentamicin and Amikacin demonstrated good susceptibility both for Gram positive and Gram negative isolates. Pipiracillin-tazobactam and Tigecycline were found most efficient antibiotics and all isolates were susceptible to them.References
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