Prevalence and Antibiotic Profile of Multidrug Resistance Gram-Negative Pathogens Isolated from Wound Infections at Two Tertiary Hospitals in Limpopo Province, South Africa: A Retrospective Study

Background: There is a high mortality and morbidity associated with multidrug resistance pathogens. The high rate of MDR isolates is gradually becoming a threat to the coverage of antibiotics including the clinical outcome of infected patients. Methods: A 5-year laboratory based antibiotic susceptibility data from January 2016 to December 2020 was reviewed to determine the most prevalent MDR pathogens isolated from samples taken from patients with wound infections at Pietersburg and Mankweng Hospitals. Results: A total of 792 pathogens were analyzed. The most prevalent isolates were Klebsiella pneumoniae (23%), Pseudomonas aeruginosa (21.7%), Escherichia coli (16%), Proteus mirabilis (13.5%), Acinetobacter baumannii (9.1%) and Klebsiella oxytoca (3.8%). The overall prevalence of MDR isolates in this study was 38.1%. The distribution of MDR prevalence amongst these isolates was K. pneumoniae (20.8%), P. aeruginosa (18.8%), P. mirabilis (17.5%), E. coli (15.9%) and A. baumannii (8.3%). Of the 9 antibiotic agents tested, trimethoprim sulfamethoxazole, tigecycline and cefepime had the highest levels of resistance. The highest level of resistance was conferred by K. pneumoniae having 63% of isolates identified as MDR. The study could not determine statistical significance of any determinant of MDR. Conclusion: The study revealed that there is high rate of MDR pathogens (38.9%) in Limpopo. Majority of the pathogens were K. pneumoniae from surgical ward, which also conferred high resistance levels. A proportion of the MDR pathogens was identified as A. baumannii CRE pathogens and is noteworthy in implementation aggressive infection prevention and control strategies.