Thesis (M.Sc.(Medical Sciences)) -- University of Limpopo, 2022 / Background: Wound infections continue to be problematic in clinical practice where
empiric treatment of infections is a routine, with non-healing wounds being a burden
to the health care system. A gap has been noted between antimicrobial resistance and
demographic factors as an existing relationship. This necessitates an investigation of
patterns of isolates and susceptibility profiles of microorganisms in wounds to modify
the preventative and therapeutic strategies against the resistant strains leading to the
stall of wound healing, which could aid in empiric treatment.
Objective: The aim of this study was to determine the antimicrobial patterns and their
associated demographic determinants in bacteria isolated from patients with non healing wounds at Pietersburg and Mankweng Hospitals, Limpopo Province.
Methods: The study was conducted using antimicrobial susceptibility data collected
from National Health Laboratory Service through Academic Affairs and Research
Management System for the period 2016-2020. A total of 797 Antimicrobial
Susceptibility Test results were analysed using Statistical Package for Social Sciences
version 27.0. The susceptibility rates for the bacterial isolates by age and gender were
calculated. The mean percentages for sensitivity and resistance were also calculated.
Pearson’s Chi-square test was used to compare age and gender with drug
susceptibility. A p-value of ≤ 0.05 was considered significant.
Results: Of the 797 patient Antimicrobial Susceptibility Test results, 372 (46.7%) were
males and 425 (53.3%) females, with mean age of 31.42 ± 21.75 years. The most
common isolates were, Klebsiella pneumoniae (23%), Pseudomonas aeruginosa
(21.7%), Escherichia coli (16%) and Proteus mirabilis (13.5%). Highest percentage of
resistance to any antibiotic was amoxicillin, ampicillin (85.15%) then trimethoprim
sulfamethoxazole (60.85%), amoxicillin ampicillin (49.1%), tigecycline (46.35%),
cefepime (32.7%), gentamycin (25.4%), ciprofloxacin (22.5%), colistin (17.6%), and
meropenem (12.3%). Furthermore, the general view of the study is no statistically
clinical significance on the effect of age and gender on bacterial resistance although
statistical significance was noted on age the resistance Acinetobacter baumannii
vi
(p=0.018), and gender on K. pneumoniae (p=0.015), P. mirabilis (p=0.024). Major
resistance to A. baumannii, K. pneumoniae and P. mirabilis were from female patients.
Conclusions: The most effective antibiotics were meropenem, colistin, and
ciprofloxacin. The highest number of isolates were K. pneumoniae, E. coli, P.
aeruginosa, P. mirabilis and A. baumannii with the most effective antibiotics
gentamycin, meropenem, ciprofloxacin, and cefepime. Although the general view of
the study is that no statistically clinical significance was noted on the effect of age and
gender on bacterial resistance, it is important to note the significant observation that
there was an observed relation of age to amoxicillin-clavulanic acid and Ciprofloxacin
and gender to amoxicillin ampicillin. As such, there is insufficient evidence that
supports the effect of age and gender on antimicrobial susceptibility. The study
suggests caution against the use of amoxicillin ampicillin in the treatment of wound
infections as it confers low levels of efficacy and high resistance and ultimately the call
to revise minimum inhibitory concentrations and critical concentrations of all less effective drugs to increase their efficacy. / National Research Foundation (NRF)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/4129 |
| Date | January 2022 |
| Creators | Kaapu, Kabelo Gabriel |
| Contributors | Maguga-Phasha, N. T. C., Seloma, N. M., Lekalakala, R. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | xv, 87 leaves |
| Relation |
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