Figure 1.
Antimicrobial resistance pattern of common bacteria isolated from sSSTIs and dSSTIs against oral, injectable, and carbapenem antibiotics
| Bacterial isolate | SSTIs | Number of resistance pathogens to antimicrobial agents, n (%) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| P.O. | Injectable | Carbapenem | |||||||||
| SXT | CIP | AMC | E | DA | AK | TZP | SCF | CRO | IPM | ||
| E. coli (n = 126) | sSSTI (n = 57) | 43 (75.4) | 42 (73.6) | 22 (38.5) | - | - | 2 (3.5) | 14 (24.5) | 13 (22.8) | 38 (66.7) | 9 (15.7) |
| dSSTI (n = 69) | 48 (70) | 56 (81) | 40 (58) | - | - | 9 (13) | 23 (33) | 25 (36) | 61 (88) | 14 (20) | |
| Klebsiella spp. (n = 76) | sSSTI (n = 27) | 16 (59) | 21 (77.8) | 17 (63) | - | - | 9 (33.3) | 9 (33.3) | 10 (37) | 22 (81.4) | 7 (25.9) |
| dSSTI (n= 49) | 38 (78) | 40 (82) | 30 (61) | - | - | 20 (41) | 24 (49) | 27 (55) | 43 (88) | 17 (35) | |
| P. aeruginosa (n = 38) | sSSTI (n = 9) | 9 (100) | 6 (66.6) | - | - | - | 4 (44.4) | 4 (44.4) | 5 (55.5) | - | 6 (66.6) |
| dSSTI (n = 29) | 26 (90) | 20 (69) | - | - | - | 11 (38) | 9 (31) | 11 (38) | - | 14 (48) | |
| S. aureus (n = 57) | sSSTI (n = 14) | 8 (57.1) | 13 (92.8) | 11 (78.5) | 10 (71.4) | 3 (21.4) | - | - | - | - | - |
| dSSTI (n= 43) | 16 (37) | 39 (91) | 35 (81) | 29 (67) | 5 (12) | - | - | - | - | - | |
Demographic characteristics and distribution of cases among inpatients and outpatients suffering from sSSTIs and dSSTIs
| sSSTI n = 124 (36%) | dSSTI n = 223 (64%) | Total n = 347 | ||||
|---|---|---|---|---|---|---|
| Frequency | % | Frequency | % | Frequency | % | |
| Patient setting | ||||||
| Inpatient | 63 | 30 | 148 | 70 | 211 | 61 |
| Outpatient | 61 | 45 | 75 | 55 | 136 | 39 |
| Gender | ||||||
| Male | 88 | 38 | 144 | 62 | 232 | 67 |
| Female | 36 | 31 | 79 | 69 | 115 | 33 |
| Age (years) | ||||||
| ≤20 | 23 | 38 | 38 | 62 | 61 | 18 |
| 21–50 | 56 | 36 | 101 | 64 | 157 | 45 |
| ≥51 | 35 | 38 | 56 | 62 | 91 | 26 |
| Underlying medical condition | ||||||
| Chronic kidney disease | 47 | 37 | 80 | 63 | 127 | 37 |
| Diabetes mellitus | 36 | 39 | 56 | 61 | 92 | 27 |
| Malignancy | 13 | 28 | 33 | 72 | 46 | 13 |
| Immunosuppression | 16 | 42 | 22 | 58 | 38 | 11 |
| Chronic liver disease | 9 | 28 | 23 | 72 | 32 | 9 |
| Heart failure | 3 | 25 | 9 | 75 | 12 | 3 |
| SSTIs | ||||||
| Wound infection | 82 | 66 | - | - | - | - |
| Diabetic foot ulcer | 15 | 12 | - | - | - | - |
| Impetigo | 15 | 12 | - | - | - | - |
| Cellulitis | 12 | 10 | - | - | - | - |
| Abscess | - | - | 138 | 62 | - | - |
| Surgical site infection | - | - | 72 | 32 | - | - |
| Necrotizing fasciitis | - | - | 13 | 6 | - | - |
| Organisms | ||||||
| E. coli | 57 | 45 | 69 | 55 | 126 | 36 |
| Klebsiella spp. | 27 | 35 | 49 | 65 | 76 | 22 |
| S. aureus | 14 | 24 | 43 | 76 | 57 | 16 |
| Pseudomonasaeruginosa | 9 | 24 | 29 | 76 | 38 | 11 |
| Proteus spp. | 7 | 58 | 5 | 42 | 12 | 3 |
| Acinetobacter spp. | 5 | 45 | 6 | 55 | 11 | 3 |
| Morganella morganii | 3 | 30 | 7 | 70 | 10 | 3 |
| CoNS | - | - | 6 | 100 | 6 | 2 |
| Enterococcus spp. | 2 | 40 | 3 | 60 | 5 | 1.4 |
| Streptococcus spp. | - | - | 4 | 100 | 4 | 01 |
| Aeromonas hydrophila | - | - | 1 | 100 | 1 | 0.2 |
| Streptococcuspneumoniae | - | - | 1 | 100 | 1 | 0.2 |
MDR pattern of bacteria isolated from sSSTIs and dSSTIs
| Bacterial isolate | SSTIs | Antimicrobial classes related to number (%) | |||||
|---|---|---|---|---|---|---|---|
| R1 | R2 | R3 | R4 | ≥R5 | MDR, n (%) | ||
| E. coli | sSSTI (n = 57) | 8 (14) | 8 (14) | 14 (25) | 6 (11) | 14 (25) | 34 (60) |
| dSSTI (n = 69) | 4 (6) | 8 (12) | 21 (30) | 10 (14) | 23 (33) | 54 (78) | |
| Klebsiella spp. | sSSTI (n = 27) | 2 (7) | 4 (15) | 5 (19) | 4 (15) | 9 (33) | 18 (67) |
| dSSTI (n = 49) | 2 (4) | 4 (8) | 9 (18) | 5 (10) | 25 (51) | 39 (80) | |
| P. aeruginosa | sSSTI (n = 9) | 3 (33) | 0 (0) | 1 (11) | 0 (0) | 5 (56) | 6 (66.6) |
| dSSTI (n= 29) | 4 (14) | 5 (17) | 5 (17) | 2 (7) | 9 (31) | 16 (55) | |
| S. aureus | sSSTI (n = 14) | 0 (0) | 1 (7) | 7 (50) | 3 (21) | 2 (14) | 12 (86) |
| dSSTI (n = 43) | 2 (5) | 9 (21) | 21 (49) | 4 (9) | 5 (12) | 30 (70) | |