Antibiotic Resistance Profile of Wound Infection Isolates: High Resistance to Cephalosporins and Penicillin Among Ghanaian Patients

Background and Aim: Antibiotics constitute one of the most routinely used medications in clinical settings. However, antimicrobial resistance (AMR) is inevitable and irreversible natural consequence of bacterial cell adaptation to exposure of antimicrobials. Conversely, there is limited study on antibiotic resistance pattern of bacteria isolated from infected wounds. This study assessed the prevalence and magnitude of antibiotic resistance pattern of bacteria isolated from infected wounds among Ghanaians. Methods This experimental cross-sectional study included 300 patients with suspected wound infections receiving treatment at MDS – Lancet Laboratories. Wound swabs were taken and inoculated on basic media, incubated at 37 degrees Celsius for 18 to 24 hours for the first reading and re-incubated again overnight for the second reading. Identification of isolates was based on morphological characteristics, grams stain reactions, biochemical reactions and using API 20 E/NE. Susceptibility testing was done using disc diffusion method. Statistical analyses were done using SPSS version 26.0 and GraphPad 8.0 Results The most isolated organisms causing wound infections were Escherichia coli (23.2%), Pseudomonas aeruginosa (19.8%), Klebsiella spp. (19.2%) and Staphylococcus aureus (15.2%). Susceptibility outcome revealed that aminoglycoside (Amikacin, and Gentamicin), carbapenem (Ertapenem, Imipenem, and Meropenem) and tetracycline (Tigecycline) were most effective antibiotic against Gram negative bacteria in wound infections whilst 2nd, 3rd and 4th generation cephalosporin (Cefuroxime, Ceftriaxone and Cefepime respectively), and aminopenicillin (Amoxicillin) had the highest resistant. Moreover, Gram positive bacteria such as Staphylococcus aureus and Coagulase negative Staphylococcus aureus (CNS) were most susceptible to aminoglycosides (Gentamicin), lincosamides (Clindamycin) and macrolides (Erythromycin), however had highest resistant against 1st and 2nd generation cephalosporin (Cefazolin and Cefoxitin respectively), penicillin (Augmentin and Cloxacillin) and Tetracycline. Prevalence of ESBL producing organisms isolated was 30.3% and were majorily Escherichia coli (50.0%) and Klebsiella spp (43.9%). Prevalence of MRSA organisms was 34.7%, and methicillin-resistant coagulase negative Staphylococcus aureus (MRCNS) was 66.7%. Conclusion Aminoglycosides and Linezolid are most effective against Gram positive and Gram-negative bacteria causing wound infections. However, both Gram positive and Gram-negative bacteria are resistant to 2nd generation cephalosporins and penicillin. Treatment of wound infections has to be done based on the culture and susceptibility test results.