Antibiotic Resistant Bacteria Infecting Wounds of Rural Community Dwellers in Northern Ghana

Abstract

To determine the prevalence, etiology and antibiotic susceptibility profile of bacterial agents of wound infection in rural community dwellers in the Northern region of Ghana. From August 2017 to July 2018, patients who reported with infected wound to four (4) primary health facilities were recruited after obtaining written informed consent. Wound swabs were taken from 93 participants; 59(63.4%) males and 34(36.6%) females. Wounds were aseptically swabbed and cultured. Antibiotic susceptibility tests (AST) were performed on all isolates using agar disc diffusion method according to Clinical and Laboratory Standards Institute CLSI 2013 guidelines. A total of 165 bacteria isolates were obtained from 93 wound swabs. The most predominant bacteria species were Staphylococcus aureus 38(23.0%) followed by Pseudomonas aeruginosa 27(19.7%), and Klebsiella pneumoniae 15(9.1%). Many of the isolates were from burns 61(37.0%) and diabetic wounds 33 (20.0%), with few from motor traffic wounds 5(3.0%). Most of the isolates were resistant to third generation cephalosporins. Notably, all (100%) of the Acinetobacter and Providencia species and 75% of Proteus species were resistant to ceftazidime and ceftriaxone. High resistance to ceftazidime and ceftriaxone was also observed in K. pneumoniae (53.3% and 53.3%) and E. coli (60.0% and 50.0%) respectively. Resistance in Streptococcus pyogenes to penicillin and erythromycin was 60% and 70% respectively while 10.5 % of the Staphylococcus aureus isolates were methicillin resistant (MSRA). This study revealed a wide range of bacterial agents are associated with wound infection and are resistant to commonly used antibiotics. Additionally, the study suggests relatively high antibiotic resistance is associated with community acquired infection of wounds.