Ciprofloxacin and streptomycin as drugs of choice in treatment of surgical site infections in Maiduguri

Abstract

Background: Surgical site infections (SSIs) are medical events that have direct unintended consequences on patients. They often result in increased hospitalization and a greater number of diagnostic and therapeutic procedures. In Maiduguri, they are a major source of post-operative illness among hospitalized patients. Hence, it is important to determine the scope of bacteria involvement and identify suitable antibacterial agents for effective treatment.

Objectives: The study was designed to determine the prevalence of SSIs in patients with surgical wounds, determine the antibiogram of the bacteria involved and drug of choice in the treatment of SSIs.

Methodology: The study design was cross-sectional using the qualitative approach. Patients with surgically created wounds infected (>30 days post-surgery) were enrolled between April and May 2018 at UMTH following informed consent. Swab samples were aseptically collected from the patients. The isolation and identification of bacterial isolates were done by cultural, microscopic and biochemical characterization. The antibiogram of the bacterial isolates was determined using disc diffusion method. Appropriate statistical tools were used.

Results: A total of 70 patients with surgically created wounds were enrolled. The prevalence of SSIs in patients with surgically created wounds was 95.7% (67/70). Three bacterial species were identified with S. aureus accounting for the highest proportion of 68.7% (46/67) while Klebsiella spp was (19.4 %, 13/67) and E. coli was (11.9 %, 8/67) [p<0.05]. Ciprofloxacin had the highest proportion of sensitivity against S. aureus isolates with a value of 87 %. Streptomycin is the most sensitive drug against the Gram negative organisms isolated with a sensitivity of 87.5 % and 85 % for E. coli and Klebsiella spp.,respectively.

Conclusions: These findings suggest that there is a high prevalence of SSIs in patients with surgically created wounds seen at UMTH. Ciprofloxacin and streptomycin are suitable antibacterial agents in the treatment of the condition and this could contribute to effective treatment of patients with SSIs.