A Clinico-Bacteriological Study of Pyodermas at a Tertiary Health Centre

Manisha S Basukala; Reema Shrestha; Geetika KC

Manisha S Basukala Lecturer, Department Of Dermatology and Venereology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
Reema Shrestha Associate Professor, Department Of Dermatology and Venereology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
Geetika KC Lecturer, Department Of Pathology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.

Abstract

Introduction: Bacterial infections of skin constitute a large proportion of skin diseases. Primary infections are most frequently incited by Staphylococci. They are also the most common invaders in secondary infection. The uncontrolled use of antibiotics has resulted in spread of multiresistant strains of Staphylococcus aureus. The most probable reason is the widespread use of antibiotics and often choosing an inappropriate drug. The objective of the study is to analyze the common primary and secondary pyodermas, the pattern of pathogens involved and their antibiotic sensitivity isolated from pus culture.

Methods: This study was conducted using clinical diagnosis of pyodermas, using pus culture and sensitivity pattern over a period of 1 year from January 2016 – January 2017.The ethical approval for the study was obtained from the Institute’s Ethical Board. Data was analyzed using SPSS … and expressed as descriptive statistics.

Results: During the study period, 118 pus culture and sensitivity reports were analyzed.. Males outnumbered females. Lower extremity was the commonest site of predilection. Primary pyodermas outnumbered secondary pyodermas. 27 Follicultis ( 40.2%) and 14 Infected Scabies(27.5%) were the commonest entities among primary and secondary pyodermas respectively. Staphylococcus aureus was the commonest causative agent in both primary and secondary pyoderma. It showed high sensitivity to Cloxacillin and Cephalexin and a high rate of resistance to Erythromycin and Ampicillin.

Conclusion: In patients with primary pyodermas, Cloxacillin should be the first line antibiotic used, with Erythromycin as a useful but less preferred alternative. The favoured combination of Ampicillin and Cloxacillin has little place in routine treatment of skin infections, except for cellulitis and infected eczemas. A Cephalosporin can also be used in these conditions if single drug therapy is desired. The secondarily infected ulcers are difficult to treat and would probably require the use of combination therapy in view of frequent mixed infections.

Keywords: Pus culture, Resistance, Sensitivity