Microbial Species Isolated from Infected Wounds and Antimicrobial Resistance Analysis: Data Emerging from a Three-Years Retrospective Study

Abstract

The antimicrobial resistance is a topic of global interest in the treatment of wound infections. The goal of this retrospective study was both the identification of the microorganisms responsible for wound infections and the determination of their drug susceptibility pattern. The study was performed from 2017 to 2019 and included 239 patients. Thirty-four species were isolated by culture methods and identified and analysed for their susceptibility patterns to antimicrobials through the Walk Away automated system. The presence of one species was the most frequent condition (75.3%), whereas a co-infection was detected in 24.7% of samples. The most common species were Gram-negative (57.9%), amongst which the most prevalent were Pseudomonas aeruginosa (40.2%), Escherichia coli (20.7%), Proteus mirabilis (11.2%), and Acinetobacter baumannii/haemolyticus (9.5%). Gram-positive bacteria were observed in 36.6%, Staphylococcus aureus (79.4%) being the most predominant species. At least one resistance to antibiotics was detected in 88.2% of isolates, while a multi-drug-resistance versus no less than 6 antimicrobials was detected in 29.2% of isolates. Although multi-drug resistant species and co-infections were observed, those were less frequently observed at the wound site. These conditions make the microorganisms eradication more difficult. The detection of a polymicrobial infection and multi-drug resistant microorganisms followed by a proper therapeutic treatment would lead to the resolution of the infection, promoting wound healing and the limitation of the spread of antibiotic resistance.

References 55

1. 1.

   Maillard J.Y., Kampf G., Cooper R. Antimicrobial stewardship of antiseptics that are pertinent to wounds: The need for a united approach. JAC Antimicrob. Resist. 2021;3:dlab027.

   Not in our library10.1093/jacamr/dlab027

2. 2.

   Simões D., Miguel S.P., Ribeiro M.P., Coutinho P., Mendonça A.G., Correia I.J. Recent advances on antimicrobial wound dressing: A review. Eur. J. Pharm. Biopharm. 2018;127:130-141.

   Not in our library10.1016/j.ejpb.2018.02.022

3. 3.

   Van Koppen C.J., Hartmann R.W. Advances in the treatment of chronic wounds: A patent review. Expert Opin. Ther. Pat. 2015;8:931-937.

   Not in our library10.1517/13543776.2015.1045879

4. 4.
   Treatment Strategies for Infected Wounds · 2018

   No notice
5. 5.

   Pallavali R.R., Degati V.L., Lomada D., Reddy M.C., Durbaka V.R.P. Isolation and in vitro evaluation of bacteriophages against MDR-bacterial isolates from septic wound infections. PLoS ONE. 2017;12:e0179245.

   Not in our library10.1371/journal.pone.0179245

6. 6.

   Anguzu J.R., Olila D. Drug sensitivity patterns of bacterial isolates from septic post-operative wounds in a regional referral hospital in Uganda. Afr. Health Sci. 2007;7:148-154.

   Not in our library10.5555/afhs.2007.7.3.148

7. 7.
   Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury · 2007

   No notice
8. 8.

   Agnihotri N., Gupta V., Joshi R.M. Aerobic bacterial isolates from burn wound infections and their antibiograms--a five-year study. Burns. 2004;30:241-243.

   Not in our library10.1016/j.burns.2003.11.010

9. 9.

   Puca V., Traini T., Guarnieri S., Carradori S., Sisto F., Macchione N., Muraro R., Mincione G., Grande R. The Antibiofilm Effect of a Medical Device Containing TIAB on Microorganisms Associated with Surgical Site Infection. Molecules. 2019;24:2280.

   Not in our library10.3390/molecules24122280

10. 10.

    Taati Moghadam M., Khoshbayan A., Chegini Z., Farahani I., Shariati A. Bacteriophages, a New Therapeutic Solution for Inhibiting Multidrug-Resistant Bacteria Causing Wound Infection: Lesson from Animal Models and Clinical Trials. Drug Des. Dev. Ther. 2020;14:1867.

    Not in our library10.2147/dddt.s251171

11. 11.

    Khan H.A., Baig K.F., Mehboob R. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pac. J. Trop. Biomed. 2017;7:478-482.

    Not in our library10.1016/j.apjtb.2017.01.019

12. 12.

    Jeschke M.G., Phelan H.A., Wolf S., Romanowski K., Rehou S., Saetamal A., Weber J., Schulz J., New C., Wiktor A., et al. State of the Science Burn Research: Burns in the Elderly. J. Burn Care Res. 2020;41:65-83.

    Not in our library10.1093/jbcr/irz163

13. 13.

    Han G., Ceilley R. Chronic Wound Healing: A Review of Current Management and Treatments. Adv. Ther. 2017;34:599-610.

    Not in our library10.1007/s12325-017-0478-y

14. 14.

    Dhar S., Saraf R., Singh K., Raina B. Microbiological profile of chronic burn wounds among patients admitted in burn unit. JK Sci. 2007;9:182-185.

    Not in our library

15. 15.

    Vaez H., Beigi F. Antibiotic susceptibility patterns of aerobic bacterial strains isolated from patients with burn wound infections. Germs. 2016;6:34-36.

    Not in our library10.11599/germs.2016.1087

16. 16.

    Glik J., Kawecki M., Gaździk T., Nowak M. The impact of the types of microorganisms isolated from blood and wounds on the results of treatment in burn patients with sepsis. Pol. Przegl. Chir. 2012;84:6-16.

    Not in our library10.2478/v10035-012-0002-7

17. 17.
    The Role of Pseudomonas aeruginosa Lipopolysaccharide in Bacterial Pathogenesis and Physiology · 2019

    No notice
18. 18.

    Ch’ng J.-H., Chong K.K.L., Lam L.N., Wong J.J., Kline K.A. Biofilm-associated infection by enterococci. Nat. Rev. Microbiol. 2018;17:82-94.

    Not in our library10.1038/s41579-018-0107-z

19. 19.
    Innovative Strategies Toward the Disassembly of the EPS Matrix in Bacterial Biofilms · 2020

    No notice
20. 20.

    Grande R., Puca V., Muraro R. Antibiotic resistance and bacterial biofilm. Expert Opin. Ther. Pat. 2020;30:897-900.

    Not in our library10.1080/13543776.2020.1830060

21. 21.

    Koo H., Allan R.N., Howlin R.P., Stoodley P., Hall-Stoodley L. Targeting microbial biofilms: Current and prospective therapeutic strategies. Nat. Rev. Microbiol. 2017;15:740-755.

    Not in our library10.1038/nrmicro.2017.99

22. 22.

    Anderl J.N., Franklin M.J., Stewart P.S. Role of antibiotic penetration limitation in Klebsiella pneumoniae biofilm resistance to ampicillin and ciprofloxacin. Antimicrob. Agents Chemother. 2000;44:1818-1824.

    Not in our library10.1128/aac.44.7.1818-1824.2000

23. 23.

    Neut D., Tijdens-Creusen E.J., Bulstra S.K., Van Der Mei H.C., Busscher H.J. Biofilms in chronic diabetic foot ulcers--a study of 2 cases. Acta Orthop. 2011;82:383-385.

    Not in our library10.3109/17453674.2011.581265

24. 24.

    Bjarnsholt T., Kirketerp-Møller K., Jensen P.Ø., Madsen K.G., Phipps R., Krogfelt K., Høiby N., Givskov M. Why chronic wounds will not heal: A novel hypothesis. Wound Repair Regen. 2008;16:2-10.

    Not in our library10.1111/j.1524-475x.2007.00283.x

25. 25.

    James G.A., Swogger E., Wolcott R., Pulcini E.D., Secor P., Sestrich J., Costerton J.W., Stewart P.S. Biofilms in chronic wounds. Wound Repair Regen. 2008;16:37-44.

    Not in our library10.1111/j.1524-475x.2007.00321.x

26. 26.

    Kennedy P., Brammah S., Wills E. Burns, biofilm and a new appraisal of burn wound sepsis. Burns. 2010;36:49-56.

    Not in our library10.1016/j.burns.2009.02.017

27. 27.

    Fromantin I., Watson S., Baffie A., Rivat A., Falcou M.C., Kriegel I., De Rycke Ingenior Y.A. A prospective, descriptive cohort study of malignant wound characteristics and wound care strategies in patients with breast cancer. Ostomy Wound Manag. 2014;60:38-48.

    Not in our library

28. 28.

    Kathju S., Nistico L., Hall-Stoodley L., Post J.C., Ehrlich G.D., Stoodley P. Chronic surgical site infection due to suture-associated polymicrobial biofilm. Surg. Infect. (Larchmt). 2009;10:457-461.

    Not in our library10.1089/sur.2008.062

29. 29.

    Howell-Jones R.S., Wilson M.J., Hill K.E., Howard A.J., Price P.E., Thomas D.W. A review of the microbiology, antibiotic usage and resistance in chronic skin wounds. J. Antimicrob. Chemother. 2005;55:143-149.

    Not in our library10.1093/jac/dkh513

30. 30.

    World Heath Organitazion. Ten Threats to Global Health in 2019.

    Not in our library

31. 31.

    World Health Organization. Antimicrobial Resistance Global Report on Surveillance: 2014 Summary. 2014;6.

    Not in our library

32. 32.

    Rice L.B. Federal Funding for the Study of Antimicrobial Resistance in Nosocomial Pathogens: No ESKAPE. J. Infect. Dis. 2008;197:1079-1081.

    Not in our library10.1086/533452

33. 33.

    Boucher H.W., Talbot G.H., Bradley J.S., Edwards J.E., Gilbert D., Rice L.B., Scheld M., Spellberg B., Bartlett J. Bad Bugs, No Drugs: No ESKAPE! An Update from the Infectious Diseases Society of America. Clin. Infect. Dis. 2009;48:1-12.

    Not in our library10.1086/595011

34. 34.

    Li B., Webster T.J. Bacteria antibiotic resistance: New challenges and opportunities for implant-associated orthopedic infections. J. Orthop. Res. 2018;36:22-32.

    Not in our library10.1002/jor.23656

35. 35.

    Zimlichman E., Henderson D., Tamir O., Franz C., Song P., Yamin C.K., Keohane C., Denham C.R., Bates D.W. Health care-associated infections: A meta-analysis of costs and financial impact on the US healthcare system. JAMA Intern. Med. 2013;173:2039-2046.

    Not in our library10.1001/jamainternmed.2013.9763

36. 36.

    Guan H., Dong W., Lu Y., Jiang M., Zhang D., Aobuliaximu Y., Dong J., Niu Y., Liu Y., Guan B., et al. Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China. Front. Med. (Lausanne). 2021;17:609584.

    Not in our library10.3389/fmed.2021.609584

37. 37.

    Rahim K., Saleha S., Zhu X., Huo L., Basit A., Franco O.L. Bacterial contribution in chronicity of wounds. Microb. Ecol. 2017;73:710-721.

    Not in our library10.1007/s00248-016-0867-9

38. 38.

    Wu Y.K., Cheng N.C., Cheng C.M. Biofilms in chronic wounds: Pathogenesis and diagnosis. Trends Biotechnol. 2019;37:505-517.

    Not in our library10.1016/j.tibtech.2018.10.011

39. 39.

    Mohammed A., Seid M.E., Gebrecherkos T., Tiruneh M., Moges F. Bacterial Isolates and Their Antimicrobial Susceptibility Patterns of Wound Infections among Inpatients and Outpatients Attending the University of Gondar Referral Hospital, Northwest Ethiopia. Int. J. Microbiol. 2017;2017:8953829.

    Not in our library10.1155/2017/8953829

40. 40.

    Yeong E.K., Sheng W.H., Hsueh P.R., Hsieh S.M., Huang H.F., Ko A.T., Tai H.C., Lai H.S., Chang S.C. The Wound Microbiology and the Outcomes of the Systemic Antibiotic Prophylaxis in a Mass Burn Casualty Incident. J. Burn Care Res. 2020;41:95-103.

    Not in our library10.1093/jbcr/irz077

Cited by papers we hold 1

• Klebsiella pneumoniae Biofilms and Their Role in Disease Pathogenesis · 2022
  Corrected

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.