Detecting Nosocomial Intrinsic Infections through Relating Bacterial Pathogens of Incision

Abstract

Surgical procedures often lead to both intrinsic and extrinsic infections. In order to improve on recovery of patients, investigations were carried out on samples collected from patients during and after surgery. Laboratory analysis was performed on wound swabs from incision, colon segments, scrapes, tissues, pus and catheter specimen urine. The samples were cultured on MacConkey and Blood agar and incubated aerobically at 370C for 16-24 hours. Thereafter, isolates were identified using standard microbiological methods. Results showed that isolates from wound were also found on endogenous indicators of surgery. Klebsiella species from incision was 15 (18.75%) while those from colon segment was 30(37.6%), scrapes 8(16%) and pus 3(7.5%). Acinetobacter species found on incision was 15(7.5%) and pus 7(2.3%). Pseudomonas species was distributed on incision 5(2.5%), colon segment 4(5%), tissue 3(1.6%), scrapes 5(10%) and pus was 5(12.5%). Staphylococcus aureus which was isolated from incision was 2(1%), while scrapes and pus were 5(10%) and 7(17.5%) respectively. Catheter associated urinary tract infections yielded significant bacteriuria (64.7%), almost twice the rate of non-significant bacteriuria (35.3%); indicating the need to remove all catheters as soon as possible. Antibiogram of isolates of Klebsiella pneumoniae with resistance pattern: ApGnNaNt, Escherichia coli (ApCtNaTtCm) and S. aureus (ApChCxErPn) with plasmid sizes in the range (30.2-52.51Kb) were common to both indicators and wound, showing that the pathogens were the same clusters. This study demonstrated surgical procedures as precursory to intrinsic infections and that bacterial pathogens found on wounds and endogenous indicators of surgery are links to intrinsic infection. The study therefore emphasizes the need to culture wounds promptly to effect speedy recovery of patients who have undergone surgery.

Key Words: Bacterial pathogens, Endogenous indicators, NosocomiaI infection, Surgery