Wound Infections in Two Health Institutions in Ile-Ife, Nigeria: Results of a Cohort Study

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Author(s): 
Adebayo Osagie Shittu, BSc, MSc; Deboye Oriade Kolawole, BSc, MSc, PhD; and Emiola Adunni Ruth Oyedepo, BSc, MSc

A wound is a breach in the skin, and exposure of subcutaneous tissue following loss of skin integrity provides a moist, warm, nutritive environment conducive to microbial colonization and proliferation.1 Wound contaminants may not persist, but species that grow and divide may become established, causing wound colonization or infection. The outcome depends on the interaction of complex host and microbial factors.2 Infection in a wound delays healing and may cause wound breakdown, herniation, or complete wound dehiscence.3

Despite technological advances in surgery and wound management, wound infection has been regarded as the most common nosocomial infection, especially in patients undergoing surgery.4 An important cause of illness, wound infection results in prolonged hospital stay and increased trauma care and treatment costs; in general, wound management practices become more resource demanding.1 The severity of complications depends largely on the infecting pathogen and site of infection.5,6 Usually, a wound can be considered infected if purulent material is observed, without the confirmation of a positive culture. The control of wound infections has become more challenging due to widespread bacterial resistance to antibiotics and to a greater incidence of infections caused by methicillin-resistant Staphylococcus aureus, polymicrobic flora, and fungi. Knowledge of the causative agents of wound infection, therefore, has proven to be helpful in the selection of empiric antimicrobial therapy and on infection control measures taken in health institutions.

This study investigated infected wounds of a patient cohort in two health institutions in Ile-Ife, Nigeria. Practitioners observed that treatment of wound infection was not guided by microbiological diagnosis, but they acknowledged that recognition of potential bacterial pathogens could assist wound care practitioners in the use of prophylactic and empiric antimicrobial therapy to aid in the prompt healing of wounds.

Material and Methods

Sample population. The prospective study included a cohort of 102 patients (70 men, 32 women, ages 2 to 72 years) presenting for wound dressing changes in the outpatient departments of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) and the Health Centre, Ile-Ife, from July to December 1994. The wound types included boils, whitlow, abscesses, permicitis, trauma wounds, postoperative wounds, burns, systemic ulcers, insect bites, and swelling of unspecified etiology. Wound sites were categorized as follows: head and neck, back and abdomen, breast, armpit, arm, hand, thigh and groin, leg, and foot regions.

References: 

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