Bacteriology and Antibiotic Sensitivity Patterns of Suppurative Hand Infections in a Tertiary Hospital in the Niger Delta, Nigeria: A 4-Year Prospective Study

Abstract

Background: Hand infections are a significant cause of morbidity and emergency surgical presentations. The anatomical complexity of the hand predisposes patients to rapid spread of infection, with severe functional consequences if management is delayed. The global emergence of Methicillin-Resistant Staphylococcus aureus (MRSA) and evolving antibiotic resistance patterns make local bacteriological data essential for guiding empirical therapy. This study evaluated the bacteriology and antibiotic sensitivity patterns of suppurative hand infections in Bayelsa State, Nigeria.

Methods: This prospective observational study was conducted from December 2020 to January 2024 at a tertiary medical facility in the Niger Delta. A total of 161 patients presenting with suppurative hand infections were enrolled. Microbiological culture and antibiotic susceptibility testing were performed on 126 patients (78.3%); the remaining 35 patients (21.7%) were not cultured due to inadequate sample volume, initiation of direct empirical treatment for clinically mild infections, or operational constraints at the time of presentation. Pus swabs or tissue aspirates were analyzed by microscopy, culture, and sensitivity (MCS). Data were analyzed using SPSS version 27.

Results: The study included 90 males and 71 females (M:F ratio 1.3:1) with a mean age of 27 ± 10 years. The most common infection types were paronychia (34.2%) and subcutaneous abscesses (21.1%). Of 126 cultured samples, Staphylococcus aureus was the predominant isolate (52.4%), followed by Streptococcus species (9.5%) and Escherichia coli (7.9%). Susceptibility testing revealed high resistance to Penicillin, Ampicillin, and Tetracycline while Ceftriaxone, Ciprofloxacin and Gentamicin demonstrated high efficacy across Gram-positive and Gram-negative isolates.

Conclusion: Staphylococcus aureus remains the primary pathogen in suppurative hand infections in this region and demonstrates significant resistance to first-line penicillins. Empirical treatment with Cephalosporins or Fluoroquinolones, combined with appropriate surgical intervention, is recommended to reduce morbidity and improve outcomes.