Monitoring the battleground: Antimicrobial resistance, antibiofilm patterns, and virulence factors of wound bacterial isolates from patients in hospital system

Extensive use of antibiotics in the treatment of bacterial infections has led to a challenge of antibiotic resistance, contributing to morbidity and mortality. Herein, evaluation of bacterial isolates from patients with wound discharge was performed and drug susceptibility patterns examined, with a goal of deciphering antibacterial resistance. A cross-sectional study was conducted between March to June 2022, in which samples were collected from patients with chronic wounds and were inoculated into appropriate media for identification and characterization. The bacterial pathogens were identified using standard microbiological methods. Shockingly, the majority of wound isolates showed positive growth in microbial analysis with high prevalence in male candidates. Further, Staphylococcus aureus 28 (20.7%) was identified as the most predominant pathogen followed by Klebsiella spp . 20 (14.8%), P. aeruginosa spp . 10 (14.8%) and lastly E. coli 6 (4.4%) bacteria in the wound isolates while cotrimoxazole 13 (48.1%) followed by clindamycin 7 (25.9%) and erythromycin 7 (25.9%) were the most antibacterial resistant drugs to both Gram positive and Gram-negative bacteria. Out of the four isolates, 3 (75%) isolates were able to produce the haemolysin and protease and 2 (50%) isolates were able to produce the lipase and phospholipase. The findings herein form a clinical basis for identification of antimicrobial resistance in chronic wounds that can be applied in responsible use of antibacterial in chronic wound management and as an illumination in development of more potent antibiotics for chronic wound treatment ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work receive no financial support from any agency ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Confidentiality and privacy were strictly adhered to and no names of individuals were recorded or made known in the reporting of information. The study was granted ethical clearance by the Institutional Research Ethics Committee (IREC) at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Not Applicable All the data are shared in all the attached documents