Antimicrobial Susceptibility Patterns of Pathogens Isolated from Surgical Site Infections at Public Health Facilities in Belize

Abstract

Surgical site infections are amongst the leading cause of morbidity, mortality and cost due to increase in hospital stay. A study was conducted to understand antimicrobial susceptibility patterns of major pathogens isolated from surgical site infections in Belize. A laboratory experiment was done to establish the antibiogram in pathogens. A retrospective study was conducted utilizing existing data captured through the Belize Health Information System, Ministry of Health. Raw data from 2009-2017, was compiled and arranged in an orderly manner and a detailed statistical analysis was carry out using SPSS and Microsoft-Excel. Descriptive analysis was conducted to extrapolate sensitivity patterns of isolates. From 630 samples only 50% (315) had pathogen growth. The number of cases reported was highest in 2013. A single pathogen was isolated from 93.3% of samples while multiple pathogens were isolated from 6.7% of samples. Out of the 341 cases where pathogens were isolated, the most common was Staphylococcus aureus (31.1%), followed by Escherichia coli (17.6%), Klebsiella spp (13.5%), Pseudomonas aeruginosa (9.7%) and Enterobacter spp. (6.45%). Aerobic Gram negative bacteria accounted for 58.1%, while aerobic Gram positive bacteria accounted for 38.4%. Cesarean procedures accounted for the highest number of infections with 28.3% while the age group most affected was between 20 - 29 years of age. Staphylococcus aureus was more resistant to Erythromycin (62.1%) and Imipenem (60%), and less resistant to Vancomycin (5.4%) and Trimethoprim/Sulphamethoxzole (8%). Escherichia coli was more resistant to Erythromycin (100%) and Tetracycline (68.2%) and less resistant to Imipenem (0%) and Amikacin (5.4%). Klebsiella spp was more resistant to Tetracycline (66.7%) and Trimethroprim/Sulphamethoxzole (62.5%) and less resistant to Imipenem (0%) and Amikacin (4.7%). The antimicrobial resistant patterns of many pathogens showed that more than 20% of all isolates were resistant to most antibiotics in all the years of the study with some isolates were seen multidrug resistant. More than 50% of all isolates during the study period showed resistance to erythromycin and more isolates were susceptible to Gentamycin.