Microbiology and drug sensitivity of Surgical Site Infections in Pakistan: A Systematic Review

                                                                                                Abstract Various bacterial pathogens that are known to cause Surgical Site Infections (SSI) are becoming increasingly resistant to many antibiotics. The aim of this systematic review was to see various pathogens responsible to cause SSI in Pakistan and to see their drug sensitivity patterns according to culture and sensitivity reports during last five years. This systematic review was conducted according to the preferred reporting items for systematic reviews and met analysis (PRISMA) guidelines. Extensive search of medical databases Pubmed, Google Scholar and Pakmedinet was done. Four studies were selected from various cities of Pakistan. Most common bacterial pathogen isolated was staph aureus 49%, followed by Ecoli 18%, Enterococcus 8%, and Pseudomonas 7.4%. Methicillin resistant staph aureus (MRSA) was isolated as 5% and 18 % in two studies. Drug sensitivity pattern showed Vancomycin, Imipenem, Meropenem, Linezolid, Cefoperazone + Sulbactam to be the most sensitive drugs against all type of pathogens. Drugs found effective against staph aureus were Vancomycin, Linezolid, Meropenem and Fusidic acid. Drugs found sensitive against E coli were Cefoperazone Sulbactam combination, Linezolid and Meropenem. Ampicillin and Amoxicillin were found highly resistant against all pathogens. We concluded from our systematic review that most common bacterial pathogen responsible to cause SSI in Pakistan is staph aureus. Empirically Linezolid is found effective against all pathogens. Imipenem, Meropenem, sulbactam plus Cefoperazone combination, vancomycin, tazocin are effective drugs. Ampicillin, amoxicillin and ciprofloxacin are highly resistant in Pakistan. Key words: Surgical Site Infections (SSI), Staph aureus, E Coli, Culture and Sensitivity