Clinico-etiological study of pyodermas in a tertiary care hospital

Pyodermas are common cutaneous bacterial infection caused mainly by Staphylococci and Streptococci.

To know clinical patterns of pyodermas, causative organisms and their antibiotic susceptibility pattern.

It is hospital based cross sectional study carried out in tertiary care hospital. Patients with pyoderma presenting to Dermatology outpatient department were taken into the study. Clinical diagnosis of pyoderma was made based on the morphology. Swabs were collected for Gram's stain and culture. The organisms isolated from culture media were tested for antibiotic sensitivity.

Three hundred cases of pyoderma were studied clinically and bacteriologically. Of these, 270 cases were of primary pyoderma and 30 were secondary pyoderma. Impetigo contagiosa was the most common type of primary pyoderma 81 (27%) followed by folliculitis 66 (22%), furunculosis 30 (10%), bullous impetigo 30 (10%), ecthyma 18 (6%), sychosis barbae 15 (5%), cellulitis 9 (3%), acute paronychia 9 (3%), periporitis 6 (2%), and carbuncle 6 (2%). Among the secondary pyodermas, infected scabies 9 (3%) and infected eczema 9 (3%) were most common. Coagulase positive Staphylococcus was isolated in majority of pyodermas. Highest sensitivity of Staphylococcus aureus was recorded to cephaloridine (95.5%) and least to ampicillin (24.8%) and penicillin (26.7%). Beta hemolytic Streptococci isolated were sensitive to cephaloridine (95.4%) followed by cefotaxime (89.3%), erythromycin (88.7%), ciprofloxacin (84.8%), ampicillin (79.6%), and tetracycline (77.2%).

With the knowledge of likely causative organism and their sensitivity patterns, proper antibiotic therapy can be given and thereby avoiding unnecessary medications known to be resistant.