Abstract

Ritul Kapoor*, Dr. Atul Khajaria, Dr. Raj Kumar

ABSTRACT

Background: Pus-forming skin and soft-tissue infections (SSTIs) are among the most common causes of outpatient visits, hospital admissions, and surgical interventions. These infections are increasingly complicated by the emergence and spread of antimicrobial resistance (AMR), leading to prolonged illness, higher healthcare costs, and increased morbidity. The bacterial profile of pus and their antimicrobial susceptibility patterns vary across regions and healthcare settings, making local surveillance essential for guiding empiric therapy and strengthening antimicrobial stewardship programs. Aim: The present study aimed to determine the prevalence of bacterial isolates from pus samples and to analyze their antibiotic susceptibility patterns in patients with wound infections attending a tertiary care hospital in Punjab, India. Materials and Methods: This prospective, observational, laboratory-based study was conducted on 250 consecutive, non-duplicate pus specimens received from patients with clinically suspected wound infections in both outpatient and inpatient departments. Specimens included pus aspirates, deep wound swabs, and tissue samples collected under aseptic conditions. Samples were processed using standard microbiological techniques, including Gram staining, aerobic culture on appropriate media, and identification by conventional biochemical methods. Antimicrobial susceptibility testing was performed by the modified Kirby–Bauer disk diffusion method, and results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Methicillin resistance in Staphylococcus aureus and extended-spectrum β-lactamase (ESBL) production among Enterobacterales were also assessed. Results: Out of 250 specimens, 175 (70.0%) yielded significant bacterial growth. Gram-negative bacilli predominated (68.57%), while Gram-positive cocci accounted for 31.43% of isolates. Escherichia coli (25.71%) was the most common isolate, followed by Staphylococcus aureus (22.86%) and Klebsiella pneumoniae (20.0%). Among S. aureus isolates, 37.5% were methicillin resistant (MRSA). ESBL production was detected in 33.3% of Enterobacterales isolates. E. coli showed high susceptibility to tigecycline (88.89%), imipenem (82.22%), meropenem (80.0%), and amikacin (80.0%), while high resistance was observed to ceftriaxone, amoxicillin–clavulanate, ciprofloxacin, and cotrimoxazole. Conclusion: The study reveals a predominance of Gram-negative pathogens and a significant burden of antimicrobial resistance in pus-forming wound infections. Aspirated pus samples provided the highest diagnostic yield. Regular monitoring of local pathogen profiles and susceptibility patterns is crucial to guide empiric therapy, improve patient outcomes, and support effective antimicrobial stewardship.