Abstract:

Introduction: Wound infection is associated with mortality, morbidity, profound discomfort and prolonged hospital stay. Due to increased types of antiseptics used for wound dressing, evaluation of their effectiveness in multi-drug resistant (MDR) bacterial load reduction is mandatory.

Methodology: It a was a cross-sectional hospital-based study conducted among 203 patients at Bugando Medical Centre (BMC) from May to August 2021. Wound swab specimens were collected and transported to Catholic University of Health and Allied Sciences (CUHAS)-Microbiology laboratory in Stuart transport media for processing. Culture was done on MacConkey agar supplemented with 2µg/ml cefotaxime and on CHROMagarMRSA for screening of Extended-spectrum beta-lactamases (ESBL) producing Gram negative bacteria and Methicillin-resistant Staphylococcus aureus (MRSA), respectively, STATA software version 13.0 was used for data analysis.

Results: Approximately half of patients’ septic wounds were caused by traffic accidents (RTA), 102 (50.2%). About 69 (34.3%) and 85 (41.9%) of septic wounds has ESBL and MRSA before wound dressing, respectively. The median ESBL bacterial load reduction before and after wound dressing was 90 (40-147) CFU/ml and 40 (18-100) CFU/ml, respectively (p-value <0.001). On the other hand, the median (IQR) MRSA bacterial load reduction before and after wound dressing was 95 (50-167) CFU/ml and 52 (21-120) CFU/ml, respectively (p-value = 0.0001). The risk factor for persistence of MDR after dressing were type of antiseptics used (less for Povidone iodine and more for Savlon and normal saline mixed other antiseptics) and diluted antiseptics.

Conclusion: Septic wound at BMC are predominantly caused by RTA. Povidone iodine strongly reduced ESBL and MRSA load post-wound dressing and can be routinely used for wound dressing. Road traffic accident victims should be a priority in the preventive measures for MDR infections.