Clinical and bacteriological profile of primary pyoderma: A cross sectional study

Abstract

Objectives: To evaluate the clinical and bacteriological profile and antibiotic susceptibility pattern in primary pyodermas. Materials and Methods: A descriptive cross-sectional study was carried out in patients with clinically diagnosed primary pyodermas and who attended the outpatient department of dermatology of a tertiary care center in South India from December 2017 to June 2019. Results: During the study period, 180 patients received a clinical diagnosis of primary pyoderma. Most common clinical type was impetigo followed by folliculitis. Most common age group affected was children below ten years of age (74 cases, 41.1%). Sixty five patients (36.1%) had lesions confined to lower limbs. Among the study participants, 26 (14.4%) were on prolonged treatment with systemic corticosteroids. Gram stain study helped in the diagnosis in 115 (63.9%) patients. Staphylococcus aureus (S. aureus) was the predominant pathogen (92 cases, 51.1%). A significant proportion of S. aureus isolates showed resistance to penicillin (90/92, 97.8%) and erythromycin (36/92, 39.1%). The pathogen isolated was methicillin resistant S. aureus (MRSA) in 28 cases (28/92, 30.4%). All isolates of Group A Streptococcus were sensitive to penicillins and first generation cephalosporins. Limitations: It was a single center study, conducted in a tertiary referral hospital; hence did not reflect the status of the disease in the community. Complete information on prior antibiotic treatment was not available in all patients. Conclusion: Pyodermas showed a predilection for younger age group. Impetigo was the leading primary pyoderma. Gram stain is a valuable, but an often neglected tool to diagnose a bacterial infection. Many isolates of S. aureus showing resistance to penicillin and erythromycin and identification of MRSA as the pathogen in many patients highlight the need for periodic assessment of pathogens and drug susceptibility patterns in different population groups to ensure judicious use of antibiotics.