The wound infection is known as the presence and growth of microbes in wound (Howell-Jones et al., 2005). The development of wound infection depends on the integrity and prospective function of skin (Sorg et al., 2017). The local wound conditions, systemic host defenses, microbial burden, and existing ailments just as outward factors, for example, pre, intra and postoperative care are the potential variables for infection of a patient. Along these lines, it is hard to foresee which wound will get infected. The general frequency of wound sepsis is from 10-33% (Neelima et al., 2013). Relative protection from anti-microbials nearly more harmful strains and ability to adjust rapidly to changing climate make the microorganisms obtained in medical clinics a matter of concern (Plummer et al., 2004). Notwithstanding current care-ful methods and the utilization of anti-infection prophylaxis, Surgical Site Infection (SSI) is one of the most widely recognized intricacies experienced in medical procedure. SSI places a critical significant on both the patient and wellbeing framework.   SSI is thus a major cause of morbidity, prolonged hospital stay and increased health costs (Mezemir et al., 2020)

Wound infection therapy with antibiotics and ideal treatment regimens remains under documented. There are many published guidelines are for the most part dependent on expert conclusion instead of proof based information. The choice of appropriate antimicrobial drugs has been uncertain. Despite the fact that prophy-lactic utilization of antimicrobials can help decrease the danger of disease and advances wound mending, its anything but an immediate substitute for good nearby twisted consideration, for example, water system and careful debridement. In addition, supported utilization of antimicrobials decreases the improve-ment of antimicrobial obstruction (AMR) (Elbur et al., 2013; Rijal et al., 2017). 

It has been revealed by reviewing of recent practices that potentially inappropriate and inconsistent use of antimicrobials following surgical procedures contri-butes to development of AMR. Likewise, fittingness of the circumstance, the span, course, and determination of these agents stays elusive (Tweed et al., 2005 and Landis et al., 2008). In Bangladesh, the efficient review and Meta analysis is planned to give cross country pooled estimates of microbial profiles, wound culture positivity, and AMR patterns of wound disease.   This will manage as a benchmark for creating anti-microbial reconnaissance programs and producing proof based determination of antimicrobials to protect the accessible antimicrobials and contain AMR. 

Study Place - This study was conducted in Micro-biology section of the Department of Laboratory Services, Khwaja Yunus Ali Medical College Hospital of remote region Enayetpur of Bangladesh from January 2019 to July 2019.

Sample Collection and Processing - All the wounds were judged as infected by the presence of purulent material. Before wound cleansing and dressing conducted pus discharge from 92 and wound swab from 203 patients were collected. Two wound swabs were collected from the wound and from a drop of aspirate using sterile cotton tipped applicators. First swab used to make smear on a clean glass slides and Gram staining was done for direct microscopic examination at 100X objective to know details bacteria-l morphology and leucocytes cells. 

Isolation and Identification - The second swab or drop of aspirate pus was utilized for culture by sterile inoculating loop on routine laboratory culture media like Nutrient Agar, Blood Agar, and MacConkeys agar, and then incubated at 37° C for 24 hrs to 48 hours aerobically.

Isolates were confirmed on standard microbiological methods. They included morphological and cultural characteristics, Gram staining, motility, hydrogen sul-phide production, indole production, carbohydrate fermentation test, and Simon citrate utilization test. Other tests include catalase test, oxidase test, coagu-lase, haemolysis on blood agar, morphological and cultural characteristics on eosin-methylene blue agar, and mannitol salt agar.

Antibiotic Sensitivity - The antibiotic sensitivity pat-tern was done by Potentiated Disc Diffusion Test (PDT) using Muller Hinton agar through following Kirby Bauers method as per standard CLSI guidelines (CLSI 2017). Commonly used antibiotics (Oxoid antibiotic disc, UK) were tested against both of both Gram positive and Gram negative bacterial isolates. 

Exclusion Criteria - Patients already on antibiotics were excluded from the study

Data Analysis - The SPSS version 16.0 was used for analysis of data. The percentage of frequencies were generated for different categorical variables such as rate of isolation, type of bacteria, rate of antibiotic sensitivity, resistance, intermediate of the organisms.

A total of 295 samples received in the laboratory were randomly selected for this study. Out of which 217 samples showed aerobic growth, and 78 remained sterile even after 48 hours incubation at 370C. Among 217 growth positive cases, 203 (68.8%) samples were from pus swab and 92 (31.2%) were from aspirate. Among 78 negative cases, 49 (62.8%) samples were from swab and 29 (37.2%) were from aspirate (Table 1 and Fig 1).

Table 1: Frequency of growth and no growth patterns in total wound samples.

Fig 1: Total number of frequency of wound infection of the suspected patients.

Table 2: Distribution Pattern of Bacterial Isolates of wound infection (n= 217). 

Majority of the wound was infected with single organism. A Gram negative Bacillus was 55.8% and Gram positive Cocci 44.2%. Most frequently isolated organisms were E. coli, 89(41%) followed by Staphylococcus. aureus 68(31%), Coagulase negative Staphylococcus, other isolates included Klebsiella spp 6(3%) and Pseudomonas aureginosa 26(12%), (Table 2). 

High number of samples (45) were collected from patients of age group 41 - 50 years and the least i.e. 09 samples were obtained from patients of age group 0 - 10 years. Among  217  positive cases, the highest posi-tive cases 118 (54.4%) were male and rest 99 (45.6%) were female (Table 3).

Antibiotic susceptibility pattern of the isolates showed imipenem 202 (93.1%), meropenem 175 (80.6%) and amikacin 166 (76.5%) were found effective for both Gram-negative and Gram-positive isolates (Shahen et al., 2019). Cephradine 48 (22.1%) was found to be weak in inhibiting both Gram-positive and gram-negative bacterial growth. For Gram-negative isolates Cephradine showed highest resistant pattern (Table 4).

Table 3: Gender and age-wise distribution of wound infected patients (n=217).

Wound contamination has been a significant worry among medical services specialists not just regarding expanded injury to the patient yet additionally taking into account its weight on money related assets and the expanding necessity for savvy the board inside the medical care framework. To take care of the serious issue of medical care framework this investigation is completed  to  discover  the  bacteriological  profile  of 

wound contaminations and antimicrobial power less-ness example of secludes. It was seen that the com-monest age bunch influenced is 21-30 years which are connected with the examinations done by Malik et al., 2011 and Afroz et al ., 2015. Regarding the sex distri-bution of the patients in the present study, males (54.4%) were affected more than females (45.6%). The possible reasons for this male preponderance can be related to socio-economic and cultural habits of earning the livelihood primarily by males and also to their adventurous nature and the greater desire to be active in comparison to their female counterparts (Kai-Yang et al., 2008). This study was correlated with Ramesh et al. (2013) which showed males (60%) more affected than females, Sowmya et al. (2014) (66.6%)  and Malik et al. (2011)  (51.9%) also showed the predominance of males over females.

In this study on wound infection five different types of organisms were identified. Highest percentage of isolation was Escherichia coli (41%), followed by Staphylococcus aureus (31%), Coagulase Negative Staphylococcus (13%), Pseudomonas aeruginosa (12%) and Klebsiella pneumoniae (3%). Similarly, Escherichia coli (55.9%) in highest percentage were detected in Dhaka, Bangladesh study on wound infection where four different types of organisms were identified (Atiyeh et al., 2007). However, Staphylo-coccus aureus (27.5%) was found as the most common isolate followed by CoNS (8.5%), (Tapan et al., 2013). The antibiogram studies indicate the emer-gence of extensively drug resistant and pandrug resistant strains. The isolates were exhibited resistance to the commonly used antibiotics as well as new generation antibiotics. In our study, most of the isolated pathogens were found sensitive to costly anti-biotics like Imipenem (93.1%), followed by Mero-penem (80.6%), Amikacin (76.5%) and least effective cheap antibiotics were Ampicillin, Amoxi-cillin, Cefixim and Cefotaxime. Amikacin was also found highly sensitive to wound infection pathogens by Neelima et al. 2013. In contrast to our study, the incidence of resistant to Meropenem (83.78%), Imipe-nem (85.41%) and Amikacin (87.03%) were found by Abedin et al. (2020).

This experiment was completed to decide bacterio-logical and antimicrobial affectability profile of wound contaminations in a tertiary care hospital of Bangladesh. This study may update the physicians in the different antimicrobial choices accessible in the treatment of wound diseases, consequently assisting with diminishing morbidity and mortality in long haul; it might decrease the expense of treatment. In our investigation assortment of aerobic bacteria are isolated from wound with prevalence of Escherichia coli followed by Staphylococcus aureus. Imipenem was the most delicate medication among both Gram positive and Gram negative bacteria and later on Amikacin and Ceftazidime was least effective (Abedin et al., 2020).  It tends to be concluded that more complete investi-gations are needed every once in a while to characterize the extent of issue and produce information for strategy choice on ideal mediation modalities.

We acknowledge the stuff of the Department of Labo-ratory Services, Khwaja Yunus Ali Medical College Hospital and Department of Microbiology, School of Biomedical Science, Khwaja Yunus Ali University, Sirajganj, Bangladesh.

Authors declare that no competing interest exists to publish the present research work.