Aetiology and antimicrobial resistance of healthcare-acquired surgical site infections occurring after hospital discharge

Aim To investigate aetiology and antimicrobial resistance of causative agents of healthcare-acquired surgical site infections (SSI) occurring after hospital discharge in the patients of Zenica-doboj Canton within the period 2002–2007.Methods Antimicrobial resistance data of etiological agents of SSI were retrospectively analysed. Antimicrobial susceptibility testing was performed by disc-diffusion method according to Clinical Laboratory Standards Institute.Results 196 wound samples of which 5 were surgical wounds were received for the analysis. Gram-negative bacteria were the more frequent causative agent in 35 (63.6%), compared to Staphylococcus aureus, which was isolated in 20 (36.4%) cases of SSI. Methicillin–resistant S. aureus (MRSA) was isolated from nine (45%) out of 20 S. aureus positive samples. Klebsiella spp. were the most frequently isolated gram-negative bacteria, 17 (48.6%) samples. MRSA isolates have shown the higher prevalence of resistance to all antibiotics tested than MSSA isolates, except for vancomycin and sulfomethoxazol-trimethoprim. High resistance rate to ciprofloxacin, 45% and 28% in both MRSA and MSSA isolates, as well as resistance to imipenem was noted, 23% and 19%, respectively. Klebsiella spp. displayed high resistance rates to all antibiotic tested, and it ranged from 12% for imipenem to 65% for sulfomethoxazol-trimethoprim. Conclusion Because of the frequency of complications, prolonged hospitalization and high costs, and ever increasing resistance to antibiotics, health-care surgical site infections are very important problem in contemporary medicine. Accordingly, there is the need to establish active monitoring of SSI in Bosnia and Herzegovina as well as continuous surveillance in order to prevent these infections.