Over years, wound infections are one of the most common hospital acquired infections and are an important cause of morbidity and account for 70–80% mortality, which can be caused by different groups of microorganisms like bacteria, fungi and protozoa. However, different microorganisms can exist in polymicrobial communities especially in the margins of wounds and in chronic wounds (Percevil and Bowler, 2001). The infecting microorganism may belong to aerobic as well as anaerobic group. Most commonly isolated aerobic microorganism include Staphylococcus aureus, Coagulase-negative staphylococci, Enterococci, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter species, Proteus mirabilis, Candida albicans and Acinetobacter (Rajendra et al., 2013; Tayfour et al., 2005).
Wound infections have been a problem and are the field of medicine for a long time. The presence of foreign materials increases the risk of serious infection even with relatively small bacterial inoculums. Advances in control of infections have not completely eradicated this problem because of development of drug resistance. The widespread uses of antibiotics, together with the length of time over which they have been available have led to major problems of resistant organisms contributing to morbidity and mortality (Elmer et al., 2007; Mulugeta and Bayeh, 2011). Hence, antimicrobial resistance can increase complications and costs associated with procedures and treatment.
Wound infections are one of the most important and potentially serious complications that occur in the acute period following injury which are subsequently colonized with microorganisms, including gram-positive bacteria, gram-negative bacteria and yeasts, which derived from the host’s normal flora (gastrointestinal flora, upper respiratory flora) and from the hospital environment (Cheure, 2002). Microorganisms may also be transferred to a patient’s skin surface via contact with contaminated external environmental surfaces, water, fomites, air, hydrotherapy treatment, and the soiled hands of health care workers. The risk of invasive wound infection is influenced by the extent and depth of the burn injury, various host factors, and the quantity and virulence of the microbial flora colonizing the wound.
The common burn wound pathogens are Pseudomonas aeruginosa, Klebsiella spp. and Staphylococcus aureus, which produce a number of virulence factors that are important in the pathogenesis of invasive infection (Sani et al., 2012). Wound especial those cause by burns are the most devastating of injuries and burn patients may suffer from their complications for the rest of their lives. In spite of the recent advances in burn care, still high mortality and significant morbidity is noted in terms of complications associated with burn wounds. In developing countries, more than 90% of fatal fire-related burns occur, over half of which alone occur in South East Asia (Ahmad et al., 2006). Data collected from different areas of the world shows that 75% of deaths in burn patients are due to infections of burn wounds (Roohul-Muqim et al., 2007). More than 10,000 African die every year from infections associated with burns. This implied that wound infections caused by burn are serious case in life threatened patient which this study tends to look for sensitive antibiotic for. Hence, the skin barrier is the natural guard to prevent the entry of pathogenic organisms inside the body. Destruction of skin barrier provides favorable entry site for the bacteria to invade and grow. Wound sepsis remains the most dangerous out-come in patients who have suffered major burn injuries and leads to overwhelming mortality among patients with extensive burn wounds.
According to research conducted by Mulugeta and Bayeh (2011), stated that burn wounds will almost inevitably be colonized by microorganisms within 24 to 48 h and this may remain as localized infection. In addition, there may bacteremia or septicemia and metastatic infections may develop at other body sites. This means that Bacteremia is a common cause of fatality in severe wound especially those cause as a result of burns patients and may occur any time from the first day until the point when all the wounds have entirely healed. Other major factors responsible for mortality in burn victims are fluid and protein loss, pulmonary edema and pneumonia (Mason et al., 1986).
The presence of large areas of devitalized, necrotic tissue, coupled with the profound immune-suppression that usually follows major burn injuries, sets the stage for rapid microbial proliferation in the wounds; when microbes invade adjacent, previously viable tissues, invasive burn wound sepsis is developed. Topical antimicrobial drugs probably have only a limited role in preventing wound sepsis, and organisms now frequently emerge that are resistant to commonly used topical agents (Hansbrough, 2007). Wound caused by injuries provide favorable sites for colonization and growth of microorganisms acquired from body’s own indigenous flora, flora of the hospital staff or from the environment surrounding these patients (Kehinde et al., 2004; Applegren et al., 2002). Immediately after injury, burned tissues contain no microorganisms. Within 24 h microbial colonization occurs. Gram Positive organisms grow first, followed by colonization of Gram negative species.
The predicted problem of mortality rises by 50% when Gram-negative organisms are associated with bacteremia in burn patients. Cost associated with the management of burn patients is also too high; which could also contribute to incomplete and hence ineffective management of burn patients, contributing to emergence of resistance in pathogens (Tayfour et al., 2005).
Increasing antibiotic use and misuse in humans, animals, agriculture, along with poor infection control strategies and some other factors have been reported for increasing resistance to commonly used antimicrobial agents (Tayfour et al., 2005). The current study will be conducted to determine the antimicrobial susceptibility of some common bacterial isolates from wounds swap in University of Abuja Teaching Hospital to help policy makers in formulation of strategies for rational and effective use of antimicrobial agents. This might help in the control of spread of antibiotic resistance genes in the community and in the reduction of morbidity and mortality associated with better management of wound patients.
Antibiotic prophylaxis is indicated in situations or wounds at high risk to become infected such as: contaminated wounds, penetrating wounds, abdominal trauma, compound fractures, lacerations greater than 5 cm, wounds with devitalized tissue, and high risk anatomical sites such as hand or foot. etc. According to Khameneh and Afshar, 2009; Rahman et al., 2002; Anguzu and Olila, (2007) recommended that prophylaxis consists of penicillin G and metronidazole given once. These indications apply for injuries which may or may not require surgical intervention. For injuries requiring surgical intervention, antibiotic prophylaxis is also indicated and should be administered prior to surgery, within the 2 hour period before the skin is cut.
However, antibiotics play an important role in the treatment of bacterial infections. Several reports indicate an increasing rate of bacterial resistance. However, this present study shall be significance to the following people: Clinicians; the ministry of Health; the government worldwide and the patient. The aim of the study was to determine susceptibility patterns of microorganisms isolated from wound swab of patient in University of Abuja Teaching Hospital, Gwagwalada Abuja.