Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin
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Annals of Clinical Microbiology and Antimicrobials Open Access
RESEARCH
Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Benin Carine Laurence Yehouenou1,2,4* , Arsène A. Kpangon5, Dissou Affolabi2,3,4, Hector Rodriguez‑Villalobos6,7, Françoise Van Bambeke1,8, Olivia Dalleur1,9† and Anne Simon6,7†
Abstract Background: Surgical site infections are related to high morbidity, mortality and healthcare costs. Because the emergence of multidrug-resistant bacteria in hospitals is becoming a worldwide challenge for surgeons who treat healthcare-associated infections, we wished to identify the causative agents involved in these infections and the rate of multidrug-resistant bacteria in six public hospitals in Benin. Methods: Using standard microbiological procedures, we processed pus specimens collected from obstetrics and gastrointestinal surgery wards. Mass spectrometry (MALDI-TOF) was used for confirmation. For the antibiotic suscepti‑ bility test, we first used the Kirby-Bauer disk diffusion method. The secondary test (by microdilution) used the Beckton Dickinson Phoenix automated system (Becton Dickinson Diagnostic, USA). Results: We included 304 patients, whose median length of stay was 9 days. A total of 259 wound swabs (85.2%) had positive aerobic bacterial growth. In obstetrics, S. aureus (28.5%, n = 42) was the most common isolate. In contrast, Gram-negative bacteria (GNB) were predominant in gastrointestinal surgery, the most dominant being E.coli (38.4%, n = 31). Overall, 90.8% (n = 208) of aerobic bacteria were multidrug resistant. Two-thirds of S. aureus (65.3%, n = 32) were methicillin-resistant Staphylococcus aureus (MRSA), three of which carried both MRSA and induced clindamycin resistance (ICR). GNB showed high resistance to ceftazidime, ceftriaxone and cefepime. Extended-spectrum beta-lac‑ tamases were presented by 69.4% of E.coli (n = 43/62) and 83.3% of K. pneumoniae (n = 25/30). Overall, twelve Gramnegative bacteria (5.24%) showed resistance to at least one carbapenem. No isolates showed a wild-type susceptible phenotype. Conclusion: This study shows the alarming prevalence of multidrug-resistant organisms from surgical site infections in Benin hospitals. To reduce the spread of such bacteria in Benin, periodic surveillance of surgical site infections and strict adherence to good hand-hygiene practice are essential. Keywords: ESBL, Methicillin-resistant staphylococcus aureus, Surgical site infection, Multidrug-resistant organisms
*Correspondence: [email protected] † Olivia Dalleur and Anne Simon are both last authors 1 Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Université Catholique de Louvain UCLouvain, Brussels, Belgium Full list of author information is available at the end of the article
Background Surgical site infections (SSIs) are infections of an incision, organ or space that occur after surgery [1]. In the United States, SSIs are the third most common hospital-acquired infections
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