Etiology and Antimicrobial Resistance Profile of Superficial Pyogenic Infections from a Tertiary Care Hospital, Western Rajasthan, India

Background: Superficial Pyogenic Infection (SPI) is the type of a pyogenic infection, which involves the infections of the skin, subcutaneous tissue, and soft tissue. These infections can cause significant morbidity. Antimicrobial Resistance (AMR) has emerged due to the rampant use of broadspectrum agents in superficial pyogenic infections. Objective: The aim of the study was to identify the microbial profile of superficial pyogenic infections and study their antimicrobial resistance. Methods: A cross-sectional observational study was carried out at the Department of Microbiology of a tertiary care hospital in the western region of Rajasthan. Samples included pus, aspirate from the abscess, necrotic tissue, and post-surgical drainage from infected skin at different sites of the patients attending OPD or admitted in IPD and ICU of the hospital. Identification of isolates was carried out by standard bacteriological techniques. The Antibiotic Susceptibility Testing (AST) of bacterial isolates was done by Kirby Bauer disk diffusion method on Mueller Hinton agar (HiMedia, India), and in a few cases, by automated Microscan system as recommended by the Clinical and Laboratory Standards Institute (CLSI), Wayne, USA. Results: A total of 2283 various specimens were obtained from different areas of healthcare facilities. Pathogenic bacterial isolates were recovered from 303 specimens. Staphylococcus aureus and Escherichia coli were found to be the main offenders. The effective antibiotics for gram-positive isolates were clindamycin, cotrimoxazole, linezolid, tetracycline, and vancomycin, and for gram-negative bacteria, meropenem, imipenem and amikacin were seen to be effective. Conclusion: This study can help formulate a local antibiotic policy which will restrict the unsupervised antibiotic use and strengthen antibiotic stewardship practices in the hospitals.