Retrospective Investigation of Antibiotic resistance pattern by Microbial pathogens isolated in surgical site infections in cancer patients

Abstract

Cancer patients are susceptible to infections as a result of their disease and the immunosuppressive medication they undergo. Surgical Site Infection (SSIs) is the third most frequent nosocomial infection in hospitals around the world, trailing only urinary tract infections and pneumonia. Exogenous and/or endogenous bacteria that enter the operative site either during surgery (primary infection) or after surgery (secondary infection) are the most common causes of SSI. Pathogens that cause SSI in cancer patients have a wide variety of microbiological spectrums and antimicrobial susceptibilities. However, there is little information on the prevalence and incidence of resistant bacteria that cause SSI, particularly in Southern India, and epidemiological data on pathogens that cause SSI in cancer patients is scarce. As a result, the current study was conducted to examine the microorganisms and its antibiotic resistance isolated from SSIs in cancer patients at North Kerala. This retrospective study was conducted at a tertiary care cancer centre in North Kerala, India during the period from May 2021 to September 2021. Data of January 2018 and December 2020 on all microbial cultures from SSI were analysed. This study comprised clinical samples such as pus, pus aspirates, and wound swabs. Identification and resistance pattern of microorganism was performed by MALDI-TOF and VITEK – 2 compact respectively. S. aureus ATCC 25923, E. coli ATCC 25922, and P. aeruginosa ATCC 27853 were used as quality control strains. During the study period, 2949 patients underwent clean and clean contaminated surgical procedures. During the study period, a total of 215 individuals (7.2%) developed SSI. A total of 215 individuals with SSI were investigated, and 224 microorganisms were identified from 190 patients. S. aureus (39%) had the greatest isolation rate among the 224 bacterial isolates, followed by P. aeruginosa. MRSA was observed in 62% of the S. aureus isolates. Among the Enterobacteriaceae, K. pneumoniae showed higher resistant to ciprofloxacin (87%), cefepime (77.4%), and amikacin (45%). Among the Non-fermenting GNB, A. baumannii showed high-level resistance when compared to P. aeruginosa. To prevent the transmission of pathogenic organisms, we encourage rigorous adherence to appropriate sanitation practises such as thorough hand washing, disinfection of inanimate objects, and other infection control measures.