Clinico, bacteriological study of pyodermas at a tertiary care hospital, Andhra Pradesh: one year study

Abstract

Background: Most of the studies in India state that pyodermas constitute 17% of cases in regular practice. Pyodermas are classified as primary and secondary. Primary pyodermas account for infection on normal skin whereas secondary on preexisting skin disease. The spectrum of pathogens, are however changing constantly as such their resistance to antibiotics. Indiscriminate usage of antibiotics, topical or systemic has lead to the development of resistance among the pathogens, which is a big problem to the physicians. The present study was conducted to assess the magnitude of different types of pyodermas, clinical types, the causative agents and their antibiotic susceptibility pattern. The study also determines the prevalence of MRSA among pyodermas.Methods: 375 newly diagnosed cases of pyodermas attending the OPD of department of Dermatology were enrolled in the study. A thorough clinical examination, demographic data, and relevant laboratory investigations were performed including culture and sensitivity.Results: The incidence of pyoderma in our study was 1.55% with male preponderance and common in 21-30 years age group. Primary pyodermas (225 cases) outnumbered secondary pyodermas (150 cases). Lower limbs were the most common site of pyodermas. Furuncle followed by folliculitis was most common primary pyodermas. Infectious eczematoid dermatitis was the most common entity in secondary pyodermas. Staphylococcus was the most common isolate in the study followed by Coagulase negative staphylococcus. Escherichia coli were most common gram negative isolate. Among diabetics, furuncle was commonest with history of 100% recurrence. Incidence of MRSA in the study was 47%. Gram negative isolates were susceptible to Carbapenems, fluroquinolones and higher generation cephalosporins.Conclusions: To conclude, our study highlighted the clinico epidemiological features of pyodermas attending our hospital. The common clinical types of primary and secondary pyodermas and associated risk factors were stated in the study. Etiological agents were identified in the study with antibiotic susceptibility, which especially assist the clinicians in selection of antibiotics in absence of culture and sensitivity.