Prevalence, resistance profiles and factors associated with skin and soft-tissue infections at Jinja regional referral hospital: A retrospective study

Skin and soft-tissue infections (SSTI) are common cases of
hospital-acquired infections with aetiologic agents exhibiting
antimicrobial resistance (AMR). We determined the prevalence, proportion
of laboratory-investigated cases, AMR-profiles, and factors associated
with SSTI and multi-drug resistance (MDR). This study was based on
archived data of patients suspected of SSTI from 2019-2021 at Jinja
Regional Referral Hospital.  The analysis involved 268 randomly
selected patient reports. Prevalence of SSTI was 66.4%.
Laboratory-investigated cases were 14.11%. Staphylococcus aureus (n=51)
was the most isolated organism. MDR pathogens explained 47% of infections.
Methicillin-resistant S. aureus was up to 44%. In addition, 61% of
Gram-negatives had the potential to produce extended-spectrum
beta-lactamases, while 27% were non-susceptible to carbapenems. Ward of
admission was significantly associated with infection (aPR=1.78, 95% CI:
1.003-3.18, p-value=0.04). Age category (19-35) was an independent
predictor for MDR infections (aPR=2.30, 95%CI:1.02-5.23, p-value=0.04).
The prevalence is relatively high with MDR pathogens responsible for
almost half of the infections. Routine use of culture and sensitivity
testing should be done for proper infection management. Gentamicin and
ciprofloxacin can be considered for empirical management of emergency SSTI
suspected of S. aureus. Recognizing SSTI under the Global Antimicrobial
resistance Surveillance System (GLASS) would lead to improved preparedness
and response to AMR.