Antibiotic susceptibility of bacterial isolates causing skin and soft tissue infections at Moi teaching and referral hospital, Eldoret, Kenya

Abstract

Background: Skin and soft tissue infections (SSTIs) are conditions resulting from the inflammatory microbial invasion of the epidermis, dermis and sub-cutaneous tissue. They are very common infections, being the second most common indication for antibiotic prescription.
Objective: To determine the antimicrobial susceptibility of bacterial organisms causing SSTIs and the antimicrobial management of SSTIs at the Moi Teaching and Referral Hospital (MTRH).
Design: A cross sectional descriptive study.
Setting: The study was carried out at Moi Teaching and Referral Hospital in Eldoret, Kenya
Subjects/Participants: Patients admitted at MTRH, whose primary diagnosis was a bacterial SSTI (cutaneous abscess, purulent cellulitis and wound infection), identified based on clinical criteria.
Result: Out of 84 bacteria cultured, Staphylococcus aureus constituted 47.6%. Methicillin Resistant Staphylococcus aureus (MRSA) constituted 45% of Staphylococcus aureus. Over 80% of Staphylococcus aureus were susceptible to vancomycin and ceftazidime. Likewise, other gram-positive bacteria, including Enterococcus spp., coagulase negative staphylococci and Streptococcus pyogenes were susceptible to vancomycin and clindamycin. Gram-negative bacteria were 25, and most were susceptible to meropenem and amikacin (>80%). However, Acinetobacter baumanii were not susceptible to any antimicrobial tested. Flucloxacillin and metronidazole were most used as empiric therapy, which was effective against the etiologic bacteria in 18%.
Conclusion: The most common cause of SSTIs was Staphylococcus aureus, which were susceptible to vancomycin and clindamycin. Gram-negative bacteria were susceptible to meropenem and amikacin. Most empiric therapy was not appropriate.