PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS OF PATHOGENS ASSOCIATED WITH PRESSURE INJURY IN IMMOBILIZED PATIENTS AT A TERTIARY HOSPITAL IN PORT HARCOURT, NIGERIA.

*Catherine Nonyelum Stanley and Dauba Margaret Princewill

ABSTRACT

Aims: This study was done to determine the prevalent microorganisms associated with pressure injuries of immobilized patients and their antibiotic susceptibility patterns. Methods: This was a cross sectional prospective study done at University of Port Harcourt Teaching Hospital (UPTH) in Port Harcourt, Nigeria. Approval was obtained from the Research and Ethics Committee of the UPTH. Samples were collected from 12 patients with pressure injuries at different wards of the UPTH and analyzed using standard microbiological methods. Antibiotic susceptibility testing was done using Bauer-Kirby disk diffusion method. Results: A total of 35 bacterial and 12 fungal isolates were obtained. The bacterial isolates in order of decreasing frequency of occurrence were Pseudomonas aeruginosa, 12 (34.3 %), Staphylococcus aureus,8 (22.8 %), Klebsiella pneumoniae, 7 (20 %), Escherichia coli 5 (14.3 %) and Coagulase negative Staphylococci 3 (8.6 %). The fungal isolates were Aspergillus fumigatus, Aspergillus niger, Penicillium notatum and Penicillium chrysogenum. Although Escherichia coli was 100% and 75% susceptible to gentamicin and levofloxacin respectively, a high level of multidrug resistance was seen among the isolates. Klebsiella pneumoniae was 100% resistant to clindamycin and erythromycin, and resistant to levofloxacin, tetracycline and ceftriaxone to varying degrees. A striking finding of this study was the development of 100 % resistance to ceftriaxone and cefoxitin by all Staphylococcus aureus and Coagulase negative Staphylococci isolated. Conclusion: Improved nursing care and stricter infection prevention and control mechanisms to combat transmission of multidrug resistant organisms in the hospital is urgently recommended.

Keywords: pressure injuries, immobilization, multidrug resistance.