Bacterial Profile, Antimicrobial Susceptibility Patterns, and Associated Factors in Wound Infection Patients at Wad Medani, Sudan: A Four-year, Laboratory-based, Retrospective, Cross-sectional Study

Background: Wound infections increase the risk of disarticulation and amputation and have significant economic repercussions. Therefore, this study aimed to identify the bacterial profiles of wound infections, patterns of antibiotic resistance, and associated factors.
Methods: This was a laboratory-based, retrospective, cross-sectional study. The study included all wound specimens for culture and drug sensitivity that were routinely obtained for diagnostic purposes at the Pathology Center for Diagnosis and Research (PCDR), University of Gezira, Sudan, from January 1, 2020, to October 15, 2023. Data were manually collected from the registries (a paper-based record) of the PCDR. Data analysis was performed using the Statistical Package for Social Sciences version 27.0.
Results: Overall, 642 wound specimens were investigated, with 450 (70.1%) cultures positive for bacterial growth. A total of 230 (51.1%) male patients had positive wound cultures. Among those with positive growth, 291(64.7%) were gram-negative bacteria (GNB) (95% CI; P-value 0.332). The most commonly isolated bacteria were Staphylococcus aureus 147 (32.7%) and Escherichia coli 145 (32.2%). Vancomycin 93.3% (43/45) and linezolid 83.7% (82/98) were the drugs most susceptible to gram-positive bacteria (GPB), while amikacin 88.7% (228/257) and gentamicin 70.6% (108/153) were the most susceptible to GNB. Univariate logistic regression revealed that only age (95% CI; P-value 0.004) had a statistical association with wound culture growth.
Conclusion: This study reported a high rate of bacterial growth. The most frequently isolated bacteria were S. aureus and E. coli. The drugs that showed the highest susceptibility to GPB were vancomycin and linezolid, while amikacin and gentamicin were the most effective against GNB. Age had a statistically significant association with wound culture growth. The high resistance rate of isolated bacteria, particularly GNB, necessitates immediate and significant modifications to their antimicrobial prescription policy for safe, rational, and effective antimicrobial administration. Additionally, antimicrobial agents should be used based on the susceptibility of specific microorganisms.