Chronic Ulcers in Ikeja-Lagos, Nigeria: an eighteen month review of infecting bacterial agents and susceptibility pattern.

BACKGROUND: Chronic ulcers are an important cause of morbidity among surgical and medical patients. Infection in ulcers may delay healing and cause septicemia resulting in mortality. Microbial studies are important for the appropriate management of these ulcers.

METHODS: Details of all patients treated for ulcers that were investigated at the department of Medical Microbiology and Parasitology, Lagos State University Teaching Hospital, Ikeja-Lagos, Nigeria between July 1st 2009 and December 31, 2010 were retrieved from the computer database and transferred into the proforma designed for the study. Data collected were demography, date of onset of ulcer, mode of specimen collection, names of isolates and drug sensitivity patterns.

RESULTS: A total of 329 cases were seen and reviewed during the study period. Males constituted 50.2%, females 38.3% and the gender of the remaining 11.6% were not indicated. There were 259 (78.7%) adults and 42 (12.8%) children. The ages of 28 cases were not indicated. Microbial growths were obtained in 217 (66.7%) patients. Gram negative (Gn) organisms were isolated in 181 (83.5%) and Gram positive (Gp) in 35 (16%). The most common isolates were Pseudomonas aeruginosa (19.1%) Staphylococcus aureus (9.7%), Proteus mirabilis (7.6%) and Escherichia coli (7.3%). There were widespread resistances by the isolates to the common antibiotics in the study environment.

CONCLUSIONS: The wide spread resistance may be due to lack of an antibiotic use policy. Certain antibiotics should be reserved for second line treatment in the emergency setting.