TY - JOUR
T1 - Chronic wounds in Sierra Leone
T2 - pathogen spectrum and antimicrobial susceptibility
AU - Schaumburg, Frieder
AU - Vas Nunes, Jonathan
AU - Mönnink, Giulia
AU - Falama, Abdul-Mac
AU - Bangura, James
AU - Mathéron, Hanna
AU - Conteh, Amara
AU - Sesay, Maxwell
AU - Sesay, Aminata
AU - Grobusch, Martin P.
N1 - Funding Information: We are grateful for the support by all laboratory technicians of the bacteriological laboratories in Masanga and Münster. This work was supported by the programme “Klinikpartnerschaften” of the “Deutsche Gesellschaft für Internationale Zusammenarbeit“ and Else-Kröner Fresenius foundation (grant: 81233012) and the Deutsche Forschungsgemeinschaft (grant: SCHA 1994/5-1). Funding Information: We are grateful for the support by all laboratory technicians of the bacteriological laboratories in Masanga and Münster. This work was supported by the programme “Klinikpartnerschaften” of the “Deutsche Gesellschaft für Internationale Zusammenarbeit“ and Else-Kröner Fresenius foundation (grant: 81233012) and the Deutsche Forschungsgemeinschaft (grant: SCHA 1994/5-1). Publisher Copyright: © 2022, The Author(s).
PY - 2022/8
Y1 - 2022/8
N2 - Purpose: Chronic wounds are frequently caused by, or super-infected with, a broad spectrum of bacteria. To guide treatment, healthcare providers need to know the bacterial spectrum and antimicrobial resistance rates to be anticipated. As these data are largely missing for Sierra Leone, we performed a microbiological study on chronic wound infections. Methods: Wound swabs were analysed for bacteria using culture-based methods. Antimicrobial susceptibility testing was done with Vitek2® automated system and EUCAST clinical breakpoints. Selected resistance phenotypes were confirmed by molecular methods (e.g. mecA/C) and genotyping. Results: Of 163 included patients, 156 (95.7%) had a positive wound culture. Pseudomonas aeruginosa (n = 75), Klebsiella pneumoniae (n = 42), Proteus mirabilis (n = 31), Staphylococcus aureus-related complex (n = 31) were predominant. Among Gram-negative rods, resistance rates were high for piperacillin/tazobactam (3–67%), cefotaxime (19–71%), and ciprofloxacin (13–60%). Among isolates of the S. aureus-related complex, 55% were methicillin resistant (CC8, PVL-negative). Conclusion: The high antimicrobial resistance rates in bacteria from chronic wounds strongly speaks against the use of empirical systemic antibiotic therapy if patients do not show signs of systemic infections, and supports the strategy of local wound care.
AB - Purpose: Chronic wounds are frequently caused by, or super-infected with, a broad spectrum of bacteria. To guide treatment, healthcare providers need to know the bacterial spectrum and antimicrobial resistance rates to be anticipated. As these data are largely missing for Sierra Leone, we performed a microbiological study on chronic wound infections. Methods: Wound swabs were analysed for bacteria using culture-based methods. Antimicrobial susceptibility testing was done with Vitek2® automated system and EUCAST clinical breakpoints. Selected resistance phenotypes were confirmed by molecular methods (e.g. mecA/C) and genotyping. Results: Of 163 included patients, 156 (95.7%) had a positive wound culture. Pseudomonas aeruginosa (n = 75), Klebsiella pneumoniae (n = 42), Proteus mirabilis (n = 31), Staphylococcus aureus-related complex (n = 31) were predominant. Among Gram-negative rods, resistance rates were high for piperacillin/tazobactam (3–67%), cefotaxime (19–71%), and ciprofloxacin (13–60%). Among isolates of the S. aureus-related complex, 55% were methicillin resistant (CC8, PVL-negative). Conclusion: The high antimicrobial resistance rates in bacteria from chronic wounds strongly speaks against the use of empirical systemic antibiotic therapy if patients do not show signs of systemic infections, and supports the strategy of local wound care.
KW - Africa
KW - Antimicrobial resistance
KW - Pseudomonas aeruginosa
KW - Staphylococcus aureus
KW - Wound Infection
UR - http://www.scopus.com/inward/record.url?scp=85125086010&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s15010-022-01762-6
DO - https://doi.org/10.1007/s15010-022-01762-6
M3 - Article
C2 - 35195886
SN - 0300-8126
VL - 50
SP - 907
EP - 914
JO - Infection
JF - Infection
IS - 4
ER -