Bacterial and Fungal Isolates from Surgical Site Infections in a Point Prevalence Survey for Healthcare-Associated Infections in Nasarawa State, Nigeria
Keywords:
Healthcare-associated; surgical site; infections; isolates; antimicrobials; susceptibility.Abstract
Background: Surgical site infections (SSIs) are a group of healthcare-associated infections (HAIs) that pose a major public health challenge due to their contribution to increased morbidity, mortality, and increased cost of healthcare. Although bacteria are the usual agents associated with SSIs, fungi are now increasingly associated as well. Over 70% of bacteria associated with healthcare-associated infections are reported to be antimicrobial-resistant. Identifying these pathogens and their antimicrobial susceptibility is important in guiding therapy. This study aimed to determine the prevalence of surgical site infections, identify the associated bacterial and fungal pathogens, and determine their antimicrobial susceptibility patterns.
Methodology: The study was a point prevalence survey conducted among hospitalised patients in public health facilities across the State. The ECDC point prevalence survey protocol for HAIs was adopted for data collection. Data were collected from 208 eligible patients between February and March 2025. Wound swab samples were collected from six patients who met the case definition for SSIs. Samples were processed to isolate and identify bacterial and fungal pathogens and to determine their antimicrobial susceptibility patterns.
Results: The study found an SSI prevalence of 2.9%, constituting 33.3% of all HAIs among hospitalized patients in this study. Both bacteria and fungi were isolated from surgical sites, with Escherichia coli and Aspergillus niger being the most common bacteria and fungi, respectively. All the bacterial isolates were found to be resistant to several antimicrobial agents, while the fungal isolates had low zones of inhibition to the antifungal agents tested.
Conclusion: The co-occurrence of bacterial and fungal infections in SSI and their resistance to several antibiotics demonstrates the need to have a high index of suspicion for polymicrobial infections in surgical sites to effect appropriate treatment early and reduce the risks associated with HAIs in hospitalized patients
