Antimicrobial susceptibility patterns of surgical site infections from neurosurgical procedures at a tertiary hospital in Kampala, Uganda: A cross-sectional study

Background: Surgical site infections (SSI) remain a major cause of morbidity and mortality. The development of postoperative surgical site infections after neurosurgical procedures represents a significant threat to life and often requires immediate medical/surgical intervention. We aimed to determine bacteriological and antimicrobial susceptibility patterns in SSI from neurosurgical procedures in a sub-Saharan African hospital in Uganda. Methods: This was a cross-sectional study that was carried out in a neurosurgical ward. A semi-structured questionnaire was used to obtain participants’ socio-demographic and clinical data. During dressing changes, we swabbed any discharge from surgical sites of neurosurgical procedures aseptically and processed as per standard operating procedures in appropriate culture media. We performed susceptibility testing on Mueller Hinton agar. Results: A total of 80 patients were enrolled in the study with a mean age of 24.3 years and the majority 58/80 (72.5%) were males. The prevalence of SSI was 11/80 (13.7%) and high 7/22(31.8%) among patients aged 10 years and below. Gram-negative microorganisms constituted the highest number of isolates with 11/13(84.6%). Only 1/13 (7.7%) Enterococcus species and S. aureus Gram-positive bacteria were isolated. Among the Gram-negative microorganisms, Acinetobacter species 4/13(30.8%) and K. pneumoniae 3/13 (23.1%) were the predominant isolates. All the Gram-positive isolates showed resistance to most of the antibiotics. Conclusions: The prevalence of SSI was relatively high with a predominance of Gram-negative bacteria in the Isolates, and affecting commonly the pediatric patients. All of the isolates resisted at least two of the antibiotics. We recommend rigorous infection control measures to reduce SSI and the appropriate use of antibiotics in neurosurgical procedures.