Species Distribution of the Aerobic Bacterial Profile in Pyoderma with Special Reference to Antibiotic Susceptibility Pattern of the Isolates at a Tertiary Care Hospital of West Bengal, India

Introduction: Pyoderma is a common health problem characterised by pyogenic infections of the skin and its appendages. Though, easily treatable, the condition is known for its chronicity, recurrence and other complications. Therefore, timely recognition and prompt bacterial diagnosis with antimicrobial sensitivity is imperative for the effective management and treatment of pyoderma. It is a common bacterial skin infection accounting for nearly 25% of patients attending Dermatology Outpatient Department (OPD) in India and other tropical countries.

Aim: To determine the incidence of pyoderma in relation to age, sex and socio-economic status, to isolate and identify the common aerobic microbial pathogens associated with pyoderma prevalent in the community and antibiotic susceptibility pattern.

Materials and Methods: An institutional based cross-sectional observational study was conducted on 148 cases in Department of Microbiology, Rampurhat Government Medical College and Hospital, Burdwan, West Bengal, India, clinical features of suspected pyoderma for a period of 12 months from March 2021 to February 2022. Lesion swabs were collected and isolates were identified; antibiotic susceptibility testing was also performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines using antibiotic discs. Descriptive data was presented as count and percentages.

Results: Out of 148 samples collected, 144 (97.3%) were culture positive while, rest 04 (2.7%) were culture negative. Overcrowding and low socio-economic group were closely related with pyoderma patients. Primary pyoderma (72.2%) cases were detected more than the secondary (27.8%) cases. Impetigo contagiosa (54%) were detected more among the primary pyoderma patients. High numbers (66.7%) of pyoderma were detected among children (0-10 years). The culture positive samples were more in male patients (68.7%) than in female patients (31.3%) and mostly detected from OPD. Out of 144 isolates, 89 (61.8%) were Staphylococcus aureus, 23 (15.9%) isolates were Coagulase-negative Staphylococci (CoNS) and 04 (2.8%) were Streptococcus pyogens. Further 06 (4.2%) isolates of Pseudomonas aeruginosa, 10 (6.9%) isolates of Escherichia coli and 08 (5.5%) isolates of Klebsiella pneumonia were found.

Conclusion: The present study results suggest that the era of antibiotics has ushered in an unprecedented predominance of Staphylococcal rather than Streptococcal infections and other gram negative infections for pyoderma cases. Increasing incidence of methicillin, quinolones and amikacin resistance in Staphylococci and other gram negative isolates have limited treatment options. For this, a single infection like pyoderma is challenging in all the healthcare facility.