Bacteriological Profile and Antibiogram of Bacterial Isolates from Pus

Samples in Tertiary Care Hospital of Kathmandu

Upendra Pandeya1*, Mithileshwor Raut2, Saru Bhattarai3, Padam Raj Bhatt1, Puspa Raj Dahal1
1
Department of Microbiology, Tri-Chandra Multiple Campus, Kathmandu, Nepal
2
Department of Biochemistry TUTH, Kathmandu, Nepal
3
Department of Microbiology, GoldenGate International College, Kathmandu, Nepal

*Corresponding author: Upendra Pandeya; Department of Microbiology, Tri-Chandra Multiple

Campus, Kathmandu, Nepal; Email: [email protected]

ABSTRACT
Objectives: The main aim of the study was to isolate and identify the bacterial agent and to determine
the susceptibility pattern of isolates to different antibiotics.

Methods: Thisretrospective study was conducted from February to October 2015 in microbiology
laboratoryof All Nepal Hospital Kathmandu, Nepal. The clinical specimens were processed for
isolation and identification of bacteriafollowing standard microbiological procedures. Antibiotic
susceptibility pattern of isolates were determined according to CLSI guidelines (CLSI 2014)

Results: A total of 271 clinical specimens were processed where 164 (60.5%) showed growth
positivity. A total 164 bacterial isolates were detected among which 84 (51.22%) were Gram positive
80 (48.78%) were Gram negative bacteria. Thirteen different species of bacteria were isolated. The
most prevalent isolate was Staphylococcus aureus 53 (32.30%) followed by E. coli 34 (20.80%), (CoNS)
15 (9.10%), Klebsiella pneumoniae 15 (9.10%), Enterococcus fecalis 12(7.30%), Pseudomonas aeruginosa
10 (6.10%), Acinetobacter spp. 7 (4.30%) Citrobacter spp., Proteus spp., Klebsiella oxytoca were less
common. S. aureus was most susceptible to Amikacin.Vancomycin was the most effective drugs for
Enterococcus fecalis. Among Gram negative bacteria E. coli was found most sensitive to Polymyxin B
(100%) and Imipenem (76.5%) where Pseudomonas aeruginosa was sensitive to, Amikacin, Imipenem
(80%). Polymyxin B was the most effective drugs for Klebsiella pneumoniae. Acinetobacter spp. was
found highly resistant to different antibiotics.

Conclusion: Antibiotic susceptibility evaluation showed Aminoglycosides, Phenicols Polymyxin,

and Imipenem was the most effective drugs overall.

Key words: Wound infection, Staphylococcus aureus, Antibiogram, Aminoglycosides

INTRODUCTION (i.e. microorganisms colonizing sweat glands, hair

Skin, the largest organ in the human body, plays a follicles or mucosa of gastro intestine, oropharynx,
crucial role in the sustenance of life through regulation of genitourinary tract) and the surrounding skin (File and
water and electrolyte balance, thermoregulation, and by Tan 1995; Acharya et al. 2008). Presence of pathogenic
acting as a barrier to external noxious agents including bacteria in wound doesn’t imply infection. Infection
microorganisms (Zafar et al. 2008). Agents that causes occurs when one or more of the contaminants evades
wound infection can be classified on the basis of depth the clearing effect of the host’s defenses, replicates in
of wound and likelihood that they serve as the carrier for large numbers, attacks and harms the host’s tissues
organisms that cause infection (Shrestha 2009). (Colle et al. 1996). Wound infection is a major problem
There are three major sources of wound contaminants- in Nepal. A complication of wound infection is very
exogenous sources (i.e. water-borne from water common because of poor hospital management and
related injury or microorganisms from soil in a soil- poor aseptic techniques used in hospitals during
contaminated injury or air-borne), endogenous source surgical procedure or other hospital procedure.

55 TUJM VOL. 4, NO. 1, 2017

Pandeya et al. 2017; TUJM 4(1): 55-62

MATERIALS AND METHODS Antibiotic Susceptibility Testing (AST): The antibiotic

A retrospective study was conducted February to susceptibility of isolates were determined by Kirby- Bauer
October 2015 in the laboratory of All Nepal Hospital disc diffusion method using Clinical and Laboratory
in order to find out the causative agent of wound Standard Institute (CLSI) guidelines (2014). Antibiotics
infection and their antibiotic susceptibility pattern. used were Amoxicillin, Amikacin, Azithromycin,
The population for this study was both inpatient Cefixime,,Cefotaxime, Cefoxitin, Ceftazidime,
(admitted to different wards) and outpatient who had Chloramphenicol, Colistin, Co-Trimoxazole, Doxycycline,
been requested for culture and antibiotic susceptibility Gentamicin, Imipenem, Levofloxacin, Nalidxilic acid,
from suspected wound infections by the medical
Nitrofurontoin, Norfloxacin, Ofloxacin, Piperacillin/
practitioners or by physicians Macroscopic examination
Tazobactam, Polymyxin B and Tigecycline. Those
was carried out to note the colour, consistency and
isolates which were non susceptible (either a resistant
the presence of granules. All wound swab specimens
or intermediate) to three or more antibiotic classes were
were inoculated on Blood Agar (BA) plate, MacConkey
regarded as MDR (Magiorakos et al. 2011).
Agar (MA) and nutrient agar (NA) and incubated at
37º for 18-24 hours. (Benson 2001; Cheesbrough 2006) RESULTS
Preliminary identification of bacterial isolates were done Out of 271 samples studied 153 (56.5%) were pus
bypigmentation, haemolysis on BA and also by Gram swab and 118 (43.5%) were aspirated pus in which
staining Conventional biochemical tests were performed 164 (60.5%) samples showed bacterial growth while
from primary cultures for identification of the isolates. 107 (39.5%) samples showed no growth. Among 164
Gram negative rods were identified by performing a positive samples, 89 (54.3%) were aspirated pus and 75
series of biochemical tests namely: catalase test, oxidase (45.7%) were pus swab that shown growth positive.
test methyl-red (MR) test, Voges-Prouskaure (VP) test
indole test, motility ,hydrogen sulphide (H2S) production Distribution of Bacterial agents
test, triple sugar iron (TSI), Citrate utilization and urease Among 164 growth positive sample most prevalent
test. Gram positive cocci were identified by catalase test, bacteria was S. aureus (32.3%) which was followed by
oxidase test, OF test and coagulase test (Benson 2001; E. coli (20.7%). The least isolated bacteria was Proteus
Cheesbrough 2006). mirabils (0.6%).

Figure 1: Percentage distribution of total bacterial isolates from wound

VOL. 4, NO. 1, 2017 56

 Pandeya et al. 2017; TUJM 4(1): 55-62

Antibiotic Susceptibility Pattern of the Bacterial Isolates by Imipenem (76.5%) and Amikacin (70.6%). The least
Antibiotic susceptibility pattern of E. coli: Among effective antibiotic was Ampicillin (100%) resistant
different antibiotics used the most effective antibiotic followed by Cefepime and Ceftazidime were (88.2%)
was Polymyxin B which was 100% sensitive followed resistant.

Table 1: Antibiotic susceptibility pattern of E. coli

Sensitive Intermediate Resistant
Antibiotics Total
No % No % No %
Ampicillin - - - - 34 100 34
Cotrimoxazole 9 26.5 - - 25 73.5 34
Ciprofloxacin 6 17.6 3 8.8 25 73.5 34
Chloramphenicol 19 55.9 2 5.9 13 38.2 34
Imipenem 26 76.5 2 5.9 6 17.6 34
Amikacin 24 70.6 - - 10 29.4 34
Gentamicin 23 67.6 - - 11 32.4 34
Cefepime 4 11.8 - - 30 88.2 34
Ceftazidime 4 11.8 - - 30 88.2 34
Cefotaxime 10 29.4 - - 24 70.6 34
Tetracycline 5 14.7 2 5.9 27 79.4 34
Polymyxin B 34 100 - - - - 34
Piperacillin/Tazobactam 17 50 9 26.5 8 23.5 34

Antibiotic susceptibility pattern of Pseudomonas of 80% followed by Gentamycin and Piperacillin/

aeruginosa: The most effective antibiotic for Tazobactam of 70% sensitivity. The least sensitive
the Pseudomonas aeruginosa was Amikacin, antibiotic was Tetracycline (20%).
Chloramphenicol, and Imipenem having the sensitivity

Table 2: Antibiotic susceptibility pattern of P. aeruginosa

Sensitive Intermediate Resistant

Antibiotics Total
No % No % No %
Ampicillin - - - - 10 100 10
Ceftazidime 3 30 - - 7 70 10
Gentamicin 7 70 - - 3 30 10
Amikacin 8 80 - - 2 20 10
Cefepime 3 30 - - 7 70 10
Ciprofloxacin 5 50 2 20 3 30 10
Chloramphenicol 8 80 - - 2 20 10
Imipenem 8 80 - - 2 20 10
Tetracycline 2 20 - - 8 80 10
Piperacillin/Tazobactam 7 70 2 20 1 10 10

Among different antibiotics used the most effective Piperacillin/Tazobactam (73.2%). The least effective
antibiotic was Polymyxin B (100%) and followed by antibiotic was Ampicillin (100%) and Ceftazidime (86.7%).

57 TUJM VOL. 4, NO. 1, 2017

Pandeya et al. 2017; TUJM 4(1): 55-62

Table 3: Antibiotic susceptibility pattern of Klebsiella pneumoniae

Susceptibility pattern
Antibiotics used Sensitive Intermediate Resistant
No. % No. % No. %
Ampicillin - - - - 15 100
Gentamicin 6 40 - - 9 60
Amikacin 8 53.3 1 6.7 6 40
Cefepime 5 33.3 - - 10 66.7
Cefotaxime 4 26.7 - - 11 73.3
Ciprofloxacin 4 26.7 - - 11 73.3
Imepenem 8 53.3 - - 7 46.7
Ceftazidime 2 13.3 - - 13 86.7
Chloramphenicol 6 40 - - 9 60
Cotrimoxazole 5 33.3 - - 10 66.7
Piperacillin/Tazobactam 11 73.3 2 13.3 2 13.3
Polymyxin B 15 100 - - - -
Tetracycline 6 40 - - 9 60

The most effective drug against S. aureus was antibiotics used least effective was Penicillin (96.2%).
Amikacin (94%) followed by Gentamycin (92.5%) CoNS were highly sensitive towards Amikacin and
and Chloramphenicol (77.4%). Among different Chloramphenicol (80% both) and Gentamicin (66.7%).

Table 4: Comparative antibiotic susceptibility pattern of S. aureus and CoNS

S.aureus (%) (N=53) CONS (%) (N=15)
Antibiotic
S I R S I R
Penicillin 3.8 - 96.2 13.3 - 86.7
Erythromycin 37.3 9.4 52.8 20 13.3 66.7
Cotrimoxazole 32.1 7.5 60.4 33.3 13.3 53.3
Tetracycline 52.8 - 47.2 53.3 - 46.7
Chloramphenicol 77.4 - 22.6 80 - 20
Ciprofloxacin 39.6 9.4 50.9 46.7 - 53.3
Gentamicin 92.5 1.9 5.7 66.7 - 33.3
Amikacin 94.3 1.9 3.8 80 - 20

The most effective antibiotic for E. fecalis was whereas least effective antibiotic was Ciprofloxacin
Tetracycline, Chloramphenicol and Vancomycin (100%) (58.3%).

Table 5: Antibiotic susceptibility pattern of Enterococcus fecalis

Sensitive Intermediate Resistant
Antibiotics Total
No % No % No %
Ampicillin 8 66.7 - - 4 33.3 12
Erythromycin 6 50 2 16.7 4 33.3 12
Tetracycline 12 100 - - - 12
Chloramphenicol 12 100 - - - - 12
Ciprofloxacin 5 41.7 - - 7 58.3 12
Gentamicin 8 66.7 - - 4 33.3 12
Vancomycin 12 100 - - - - 12

VOL. 4, NO. 1, 2017 58

 Pandeya et al. 2017; TUJM 4(1): 55-62

DISCUSSION (46.3%) from outpatients shown microbial growth.

Wound infection has been major concern among health
On total growth positive pus samples, 84(51.22%) were
care practitioners not only in terms of increased trauma
Gram positive bacteria. Among Gram positive bacteria,
but also in view of its burden on financial resources
S. aureus (63.1%) was the most common isolates similar
and the increasing requirements for cost effective
study conducted by Pokhrel et al. (2004) 57.66%, Bhatt
management within health care system. Infection of
and Lakhey (2007) 50%, Acharya et al. (2008) 51.2%,
wound delays in healing and may cause herniation of
showed S. aureus was the predominant in wound
the wound and complete wound dehiscence (Alexender
infection study conducted in Nepal, Mishra et al.
1994). Wound infections are also significant in that they
(2000) reported 60.1%. But Banjara et al. 2003 (24.9%)
are the most common nosocomial infection (Dongi et
from TUTH and De et al. 2003 (11.2%) from India that
al. 20011)
showed lower frequency of S. aureus. CoNS (17.9%)
The study was designed with an aim to assess the constituted second most prevalent bacteria among
prevalence of wound infection in All Nepal Hospital; Gram positive bacteria in our study. Similar study
the effect of age, gender and other co- morbid conditions carried by Neelima et al. (2013) CoNS (18.6%) was the
in the prevalence as well as identifying the etiological second predominant organisms. According to Shah et
agents and their susceptibility to antimicrobial agents. al. (1997) CoNS was 11.4% and Manyahi et al. (2012)
In this study a total 271 pus samples were collected it was the second most predominant but Altoparlak et
and processed. The etiological agents were identified al. 2004 reorted 63% of prevalence of CoNS which is
by culture and different biochemical tests and their contradictory with our findings. Similarly Enterococcus
susceptibility pattern with commonly used antibiotics fecalis (14.3%) and Streptococcus pyogenes (4.8%) was
were determined. found in our study. Yah et al. (2007) found that S.
pyogenes (3.3%) on kerosene burn wound.
In our study, out of total samples from patients with
wound infection, 60.5% showed bacterial growth In this study, antibiotic susceptibility test was
whereas 39.5% didn’t show any growth. Culture performed for all bacterial isolates. The antibiotic
negative results might be difficulty in growing of discs used were Ciprofloxacin, Cotrimoxazole,
fastidious organisms. Another possibility could be Chloramphenicol, Amikacin, Gentamicin and
manual error in collection, transport of culture media Tetracycline was common antibiotics while Ampicillin
and diagnosis of the infection itself and most probable was used for all Gram negative and Enterococcus
reason was the sample from patient taking antibiotic. fecalis. Penicillin and Erythromycin were only used for
Similar studies conducted by KC et al. 2013 (60.2%), Gram positive isolates. Vancomycin was used only for
Acharya et al. 2008 (50.7%) and Bhatt et al. 2007 (80.6%) Enterococcus fecalis. Antibiotics Ceftazidime Cefepime,
findings in Nepal. Neelima et al. (2013) 58% of the Cefotaxime, Imipenem, Piperacillin/Tazobactam
sample cultured aerobically showed positive growth. and Polymyxin B were used only for Gram negative.
A study conducted by Giacometti et al. (2000), Manyahi Cefoxitin disc was only used for S. aureus.
(2012) in tertiary hospital >90% shows growth. Both
In our study, the most effective antibiotic for E. coli
of these studies were contrary to this study. This
was Polymyxin B (100%), Imipenem (76.5%), Amikacin
difference in prevalence may be due to variation in
(70.6%), Gentamycin (67.6%) and Chloramphenicol
common nosocomial pathogens inhabitant, difference
(55.9%). Other antibiotics like Ampicillin (100%),
in policy of infection control and prevention between
Ceftazidime (88.2%), Cefepime (88.2%) and Tetracycline
countries and hospitals and study designed used in the
(79.4%) resistance to E. coli. Yakha et al. (2014) showed
researches.
Imipenem (96.4%), Amikacin (86.6%) and Piperacillin/
Out of total cases 46.9% were male patients where 53.1% Tazo (70.7%), Rao et al. (2014) reported Imipenem,
female patients. The growth was found higher in male Amikacin and Pipera/Tazo were (80%) sensitive
patients 53% and female 47%.In this study, on total while Ampicillin (53.34%), Ceftriaxone (73.34%),
sample analyzed 139 (51%) samples from outpatients Ciprofloxacin (73.34%) show higher resistance to Ecoli.
and 132 (49%) samples from inpatients while on growth E. coli showed (90.9%) resistant to Ampicillin and
positive 164 cases 88 (53.7%) from inpatients and 76 Ciprofloxacin, (81.8%) to Cefotaxim and Ceftriaxone,

59 TUJM VOL. 4, NO. 1, 2017

Pandeya et al. 2017; TUJM 4(1): 55-62

(72.7%) resistant to Cotrimoxazole. However, it was and Gentamicin and 40% of them being resistant to
highly sensitive to Amikacin (100%) followed by Carbapenams. Idomir et al. (2009) also reported all
Gentamicin (54.5%). tested antibiotics are resistant by Acinetobacter spp.
except Carbapenam.
Regarding the sensitivity pattern of Pseudomonas
spp., it was found that Amikacin, Imipenem, For Citrobacter spp. Amikacin and Polymyxin B (85.7%)
Chloramphenicol was the most effective drug was the most effective antibiotic and Imipenem and
(80%) sensitivity and Gentamycin and Piperacillin/ Pipera/Tazo (71.4%) and highly resistant to Ampicillin
Tazobactam showed 70% sensitivity while Ampicillin, (85.7%), Cefepime (100%), Cotrimoxazole (71.4%).
Cefepime and Tetracycline was the least effective Proteus spp are highly susceptible to Imipenem,
drugs. Similarly a study carried by Amatya et al. (2015) Chlormphenicol, Ceftazidime, Amikacin, Cefepime
reported Imipenem (87.9%) and Amikacin (64.6%) and Gentamicin (100%) but resistant to Polymyxin B,
sensitive similarly Acharya et al. (2008) reported Ampicillin and Cotrimoxazole (100%).
Amikacin was the most effective drug against P. Resistance to Penicillins and Cephalosporins (Levy
aeruginosa. Pseudomonas aeruginosa was sensitive to and Marshall 2004) by Gram negative bacteria is most
Gentamicin (87.5%) and Ceftazidime (85.7%) but commonly due to the production of β- lactamase,
showed resistance to Ciprofloxacin (57.2%) (Anguzu either chromosomally encoded or, more often, plasmid
and Ohila 2007). Mengesha et al. (2014) found that mediated. Other important mechanisms of resistance
P. aeruginosa were 100% resistant to Ceftriaxone, include alteration in penicillin binding protein (PBPs),
Amoxicillin, Tetracycline and Ampicillin. Similar decreased penetration of the antibiotics to the bacterial
resistant pattern was also shown by Guta et al. (2014). cell or combinations of these resistance strategies
The most effective antibiotic against Klebsiella (Deloney and Schiller 2000). Active efflux pumps in
pneumoniae was Polymyxin B (100%). Antibiotics like Gram negative bacteria which execrete drugs including
Piperacillin/Tazobactam (73.2%), Amikacin (53.3%), multidrug efflux pumps, can also confer to resistance
Imipenem (53.3%) sensitive to K. pneumoniae. The least to β-lactams
effective antibiotics are Ampicillin (100%), Ceftazidime The most effective antibiotic against S. aureus was
(86.7%), Cefotaxime and Chloramphenicol (73.3%). Amikacin (94.3%) followed by Gentamicin (92.5%)
Cotrimoxazole, Gentamicin Cefepime Tetracycline and Chloramphenicol (77.4%), only Cefoxitin (56.6%).
shows resistant above (60%). Klebsiella oxytoca is highly Antibiotics such as Erythromycin, Cotrimoxazle and
susceptible to Polymyxin B and Amikacin (100% Ciprofloxacin have sensitivity less than 40% and least
both) other antibiotics like Imipenem, Cefotaxime, effective antibiotic was Penicillin (96.2%). The result
Chloramphenicol Tetracycline Shown (50%) sensitive was similar in case of CoNS being most sensitive with
by K. oxytoca. A study conducted by Chowdhury et Chioramphenicol (80%), Amikacin (80%), followed
al. (2013) reported Klebsiella are highly sensitive to by Gentamicin (66.7%), Tertacycline (53.3%) and
Imipenem (100%) and Gentamicin Ceftazidime and Cefoxitine (53.3%) sensitive.
Ceftriaxone are highly resistant to Klebsiella spp.
The least effective antibiotic was Penicillin (86.7%),
Similarly Rao et al. (2014) have similar result with the
Erythromycin and Cotrimoxazole. A study carried
present study, which shows maximum sensivity to
out by Amatya et al. (2015) in B & B Hospital Nepal,
Imipenem, Amikacin and Piperacillin/Tazobactam
Chloramphenicol (89.1%) and Gentamicin (52.2%)
(76.92%) of each, but higher resistant to Ciprofloxacin,
which is similar to our findings. Poudel (2013) reported
Ampicillin and Cefotaxime.
that Chloramphenicol (98.9%) and Gentamicin (86.8%)
In the present study, isolates of Acinetobacter spp. was was the most effective antibiotics against S. aureus
found highly resistant to commonly used antibiotics which agreed with our findings. Andhoga et al. (2002)
Ampicillin, Ceftazidime, Cefotaxime (100%) and in Kenya have reports S. aureus being highly resistance
Tetracycline (71.4%), Amikacin (57.1%), Gentamycin to Chloramphenicol (84.8%). S. aureus causes clinically
(71.4%). Whereas Imeipenem (57.1%) sensitive. relevant infections mostly because of its virulence
Manyahi (2012) reported that Acinetobacter spp. factors such as coagulase, catalase clumping factor A
were highly resistant to Ceftazidime, Ciprofloxcin and leucocidines (Dissemond 2009).

VOL. 4, NO. 1, 2017 60

 Pandeya et al. 2017; TUJM 4(1): 55-62

CONCLUSION of bacterial isolates from septic Post-operative

In this study Gram positive bacteria was found wounds in a regional referral Hospital in Uganda.
predominant over Gram negative bacteria. The most Africian Journal of Health Science 7:14854
common isolates were S. aureus (32.3%), E. coli (20.7%),
Banjara MR, Sharma AP, Joshi AB, Tuladhar NR,
K. pneumoniae (9.1%) and P. aeruginosa (6.1%). Pattern
Ghimire P and Bhatta DR (2003) Surgical wound
of bacterial isolates were similar in both inpatient and
infections in patients of TU teaching. J Nepal
outpatients. The least effective antibiotic was Ampicillin
Health Res Council 1(2): 41-45.
(100% resistant) in case of Gram negative and Penicillin
(100% resistant) in case of Gram positive. Acinetobacter Benson T (2001) Microbiological applications laboratory
spp. was highly resistant to different antibiotics. manual in general Microbiology. 8th Edition, The
Polymyxin B was the most effective antibiotic against McGraw-Hill, New York.
Gram negative bacteria like E. coli, Klebsiella spp., Bhatt CP and Lakhey M (2007) The distribution of
Proteus spp. and Citrobacter spp. Antibiotics like pathogens causing wound infection and their
Amikacin, Gentamicin and Chloramphenicol were antibiotic susceptibility pattern. J Nepal Health Res
highly effective to Gram positive bacteria. Council 5: 22-26.
ACKNOWLEDGMENTS Cheesbrough M (2006) District laboratory practice in
Authors would like to thank all the patients who agreed
tropical countries part 2. 2nd edition. Cambridge
to participate in this study and made this research
University Press, New York.
possible. Furthermore extend our gratitude to All
Nepal Hospital for providing the necessary laboratory Chowdhury D, Jhora ST, Shah MR and Nahar N (2013)
facility. Antibacterial resistance pattern of common
bacterial pathogen in tertiary care hospitals in
REFERENCES
Dhaka City. Bangladesh J Med Microbiol 07: 13-16.
Acharya J, Mishra SK, Kattel HP, Rijal BP and Pokhrel
BM (2008) Bacteriology of wound infection CLSI, Performance Standards for Antimicrobial
among patients attending TU Teaching Hospital, Susceptibility Testing; Twenty-Fourth
Kathmandu Nepal. JNAMLS 9: 76-80 Informational Supplement. M100-S24, January
2014, 34: 1.
Alexender MF (1994) Wound infection. in.; nursing
practice hospital and home, Margaret F. Collee JG, Duguid JP, Fraser AG, Marmion BP and
Alexender, Josephine N. Fawcett, Phyllis J. Simmons A (1996) Laboratory strategy in the
Rucimang (eds). Churchill Livingstone, New diagnosis of infective syndromes. Mackie and
York. Pg. 703. McCartney practical medial microbiology; 14th
edition. Churchill Livingstone pp 53-94.
Altoparlak U, Erol S, Akcay MN, Celebi F and Kadanali
A (2004) The time related changes of antimicrobial De A, Varaiya A, Mathur M and Bhesania A (2003)
resistance patterns and predominant bacterial Bacteriological studies of gas gangrene and
profiles of burn wounds and body flora of burned related infections. Indian J Med Microbiol 21: 202-
patients. 30: 660-664. 204.

Amatya J, Rijal M and Baidya R (2015) Bacteriological Deloney CR and Schiller NL (2000) Characterization of
study of the postoperative wound samples and an in vitro selected amoxicillin-resistant strain of
antibiotic susceptibility pattern of the isolates in Helicobacter pylori. Antimicrob Agents Chemother
B & B Hospital. JSM Microbiology 3:1019. 44: 3368-3373

Andhoga J, Macharia AG, Maikuma IR, Wanyonyi Dissemond J (2009) Methicillin resistant Staphylococcus
ZS, Ayumba BR and Kakai R (2002) Aerobic aureus (MRSA): diagnostic, clinical relevance and
pathogenic bacteria in post- operatie wounds at therapy. J Dtsch Dermatol Ges 6: 544-551.
MOi Teaching and Referral Hospital. East Afr
Dongi R, Rovera F, Dionigi G, Imperatori A, Ferrari A,
Med J 79: 640-644.
Dionigi O and Dominioni I (2001) Risk factors in
Anguzu JR and Ohila D (2007) Drug sensitivity pattern Surgery. Journal of Chemotherapy 13: 6-11.

61 TUJM VOL. 4, NO. 1, 2017

Pandeya et al. 2017; TUJM 4(1): 55-62

File TM and Tan JS (1995) Treatment of skin and soft Antibiotic resistance pattern of isolates from
tissue infections. Am J Surg 169: 27-33. Wound and soft tissue infections. MJAFI 56

Giacometti A, Cirioni O, Schimizzi AM, Del MS, Prete F, Neelima, Pravin DK, Suresh P and Nandeeshwar (2013)
Barchiesi M.M.D, Errico E, Petrelli G and ScaliSe J Bacteriological profile of wound infection in rural
(2000) Epidemiology and microbiology of surgical hospital in R.R district. Int J Med Res Health Sci 2:
wound infection. J Clin Microbiol 38: 918-922. 469-473.
Guta M, Aragaw K, and Merid Y (2014) Bacteria from Pokhrel BM and Shrestha L (2004) Microbiology of
infected surgical wounds and their antimicrobial burns wound in children. JNAMLS 6: 7-10.
resistance in Hawassa University Referral
Teaching Hospital, Southern Ethiopia. AJMR 8: Poudel P (2013) Bacteriological spectrum of wound
1118-124. infection and their antibiogram in a tertiary
care hospital. A dissertation presented to the
Idomir M, Netmet C, Pascu A and Ardeleanu M (2009)
Department of Microbiology, Tri-Chandra
Acinetobacter spp. pathogenic role and resistance
Multiple Campus, Tribhuvan University,
to antibiotics. Bulletin of the Transilvania University
Kathmandu Nepal.
of Brasov 2: 56-59.
Shah PK, Pokhrel BM and Sharma AP (1997) The
KC R, Shrestha A and Sharma VK (2013) Bacteriological
incidence of coagulase negative Staphylococci in
study of wound Infection and antibiotic
Nepalese people. Nep Med Assoc 123: 296-300.
susceptibility pattern of the isolates. Nepal Journal
of Science and Technology 14: 143-150. Rao R, Ranjan B and Debika RB (2014) Aerobic bacterial
Levy SB and Marshall B (2004) Antibacterial resistance profile and antimicrobial susceptibility pattern
worldwide: causes, challenges and responces. of Pus isolates in a South Indian Tertiary Care
Nature medicine supplement. 10: S122-S129. Hospital. IORS-JDMS e-ISSN: 2279-0853, p-ISSN:
2279-0861. 13(3): 59-62
Magiorakos AS, Srinivasan A, Carey RB, Carmeil Y,
Falagus ME, Giske CG, Harbarth S, Hindler JF, Shrestha P (2009) Study of bacteriological profile of
Kahlmeter G, Olsson liljequist B, Paterson DL, infected wound from patients visiting Kanti
Rise LB, Stelling J, Struelens MJ, Vatopoulos children’s hospital, Maharajgunj, Kathmandu.
A, Weber JT and Monnet DL (2011) Multidrug A M.Sc. dissertation presented to the Central
resistant, extensively drug resistant and pandrug Department of Microbiology, Tribhuvan
resistant bacteria: An international expert University, Kathmandu, Nepal. pp 5-70.
proposal for intense standard definition for
Yah SC, Eghafona NO, Oranusi S and Abouo AM
acquired resistance. Clinical Microbiology and
(2007) Wide spread plasmid resistance genes
Infection ECDC 18: 268-281.
among Proteus spp. in diabetic wounds patients
Manyahi J (2012) Bacteriological Spectrum of in ABUTH Zaria. Afr J Biotechnol 6: 1757-1762.
post-operative wound infections and their
antibiogram in a tertiary hospital, Dares Salaam, Yakha JK, Sharma AR, Dahal N, Lekhak B and Banjara
Tanzania. A dissertation Submitted in Fulfillment MR (2014) Antibiotic susceptibility pattern of
of the Requirement for the Degree of Master bacterial isolates causing wound infection among
of Medicine (Microbiology and Immunology) the patients visiting B & B Hospital. Nepal Journal
of Muhimbili University of Health and Allied of Science and Technology 15: 91-96.
Sciences Muhimbili University of Health and
Zafar A, Anwar N and Ejaz H. (2008). Bacteriology
Allied Sciences.
of infected wounds- A study conducted at
Mishra RN, Chander Y, Debata NK and Ohri VC (2000) Children’s Hospital Lahore. Biomedica 24: 71-74.

VOL. 4, NO. 1, 2017 62