The isolation and identification of bacteria associated with 150ml sepsis studies were carried out to 250 patient at National Orthopedic Hospital Enugu. (250) Two hundred and fifty patients with 150ml sepstis was grouped in to in patients and out patients. The sample collected are wound pus and wound exudates which were collected from patients with diabetic ulcer, surgery wounds, sickle cell ulcers, gun shot wound, using sterile stent striates to aspirate the wound exudates and steete swab sticks to swab the wound prof. Population was sampled

According to wound type and noting their differences sex distributing palternage range (0-2_ years, (3-5_ years (608) years (9-11_ years, (12-14) years, (15-17) years, (18-20) years, and 21 years and above, in sex distribution. (male and female), in predisposing factors and in any other factor affecting it and also their anatibiotic sensitivity pattern. The samples collected were plated out to on Mac conkey agar, Blood agar, Perory citrate agar (DCA) and further examination was done such as motility test gram staining and some brolhemoceltest like citrate, on and catalyset test foar confirmation. The results obtained from 250 patients smaples, 199 were positive pathogens and 51 were negative out of which 97 (48.890) were staphylococcus aureus, Staphylococcus aureus was arecorded as the organism that was the highest prevelence while galmorella species has the lowest prevalence 3(1.5%) In this study. The sensivity patttern of the isolated organisms results show that pseudomonas aeruginosa is resistant to more drugs than the staphylococcus aureus and escherichris coli. Msot organisms were sensitive ato ciprofloxacillin, Amplicillin, Oxfloxacillin, Erythroylin, Cotrimoxazole.

TABLE OF CONTENTS

Title page

Certification

Dedication

Acknowledgement

Abstract

Table of contents

List of tables

List of figures

CHAPTER ONE

1.0 Introduction

1.1 complication

1.2 Aim and objectives

1.3 Statement of problems

1.4 The significance of study

1.5 Hypothesis

1.6 Scope of study

1.7 Limitation

CHAPTER TWO

2.0 Literature review

2.1 general incidence to wound sepsis

2.2 Actiological agends of wound sepsis

2.3 Diagnosis and pathogenesis of wound sepsis

2.4 Epideomology of wound sepsis

2.5 Age and sex incidence

2.6 Predisposing facST OF TABLES

2.6

2.6tor of wound sepsis

2.7 Chemo therapy of wound sepsis

CHAPTER THREE

3.0 Materials and methods

3.1 materials and culture media used

3.2 Collection and processing sample

3.3 Method

3.4 Biochemical characterization isolates

3.5 Gram staining

3.6 Catalase test

3.7 Coagulase test

3.8 Motilidy test

3.9 Oxidse test

3.10 Indole test

3.11 Methyl red test

3.12 Phenylative deamination test

3.13 Citrase utilization test

3.14 Antibigram

CHAPTER FOUR

4.0 RESULTS

CHAPTER FIVE

5.0 Discussion, suggestions, conclusions and recommendation.

5.1 Discussion

5.2 Suggestion

5.3 Conclusions

5.4 Recommendation

LIST OF TABLES

1. Subjects smapled accoridng to inpatients, out patients, age and sex distribution

2. Subjects sampled according to types of wounds, age and sex distribution

3. Paterns of organisms isolated in wounds sepsis in Enugu

4. Age and sex distribution of isolates in wound sepsis

5. Bacterial pathogens causing wound sepsis in patients with sickle cell disease in Enugu

6. Pattern of bacterial pathogens causing wound sepsis in patients with surgical wounds.

7. Bacterial isolated in patients with Gunshot wound sepsis

8. Bacterial isolated from patients with diabetes ulcers

9. Antibiogram of bacterial isolates from wound sepsis in Enugu

10. Biochemical reactions and identifications and identification test on bacterial isolates from wound sepsis in Enugu

LIST OF FIGURES

1. showing organisms isolated from wound sepsis in Enugu (piechart)

2. Bacterial pathogenesis causing wound sepsis in patients with sickle cell disease

3. Bacterial pathogens causing wound sepsis in the patients with surgical wounds (Barcharts)

4. Bacterial isolates from patients with gunshot wound (bar chart)

5. Bacterial isolates from patients with diabetic ulcer (Bar chart)

CHAPTER ONE

1.0 INTRODUCTION

Wound is any interruption, by violence or by surgery, in the continuity of the external surfaces of the body or of the surface of any internal or pan (madonald, 1990). According to him, legally, the whole thickness of the skin must be broken, and creating an internal injury wound. Is also a breach of a coetaneous, mucous or serious surface (Charles 1979). Wound can also be defied as injury to the skin or underlying tissues or organs by a blow or cut, missile or stab which includes injury to the skin caused by chemicals, cold, friction, heat, pressure and rays, and manifestation in the skin of internal conditions such as pressure sure and ulcers (Roper 1989).

Wound sepsis is the infection of wound by phylogenic organisms (Roper, 1989). Wounds can be divided into Many types which includes (a) Incised wounds: which are produced by sharp scuttling instruments (There is aponeuetic fascia of the scalp and most operations wounds are of a this category, Lacerased wounds which may be produced in category, Lacerased wounds which may be produced in road accidents, by factory machinery. This type of wound is frequently contaminated and it supplies an excellent culture medium for microorganisms. There is more pain than in an incised wound but bleeding may not be severe due to constriction of blood vessels. Punctured wound which may be inflicted by sharp instrument, nails, edge’s teeth, knives and bullets. These wounds are specially susceptible to injection from anaerobic organisms as those causing tetanus and gas gangrene which start thriving when the aerotic organisms such as staphylococcus and streptococcus have used up the available oxygen in the deep tissues.

Poisoned wounds are those which occurs as a result of insect strings, snake bites and dog bites and the inject bites produce swelling. Irritation and dis-comfort caused and devitalized wounds are those that result for industrial and severe road accidents and the area and depth of devitalized tissue depends upon the area and weight of the coushing force and the duration and velocity of impact.

Burns and scalids which results from the destruction of tissue by dry heat fraction, electricity radiation or corrosive fluid while scald results from the destruction of tissue by mist heat. Bruise and confusion is a superficient injury without damage to the skin and the swelling, pain and dis comfort are dye to the extra-vacation of blood into tissues. Colour changes occur as a result of the moglobin oxidatron.

Haematoma is the collection of blood in the tissues which causes a swelling which when pressed on surrounding structures, the haemotoma become readily injected by micro-organism

Sprain is another wound type which involves the tearing of the capsule and ligaments round a joint with subsequent exudation of fluids.

Wounds cab further be classified into clean wounds with the amount of contamination being up 30% or more in dirty wounds. The class I (clean) wounds which are non traumatic with no break in surgical technique without any septic folus or viscera being opened. Classs II (clean contaminated) wounds are non traumatic, with only minor breaker own in technique being allowed orentry into a vucous without significant spillage. The class III (contaminated) are traumatic wounds froma relatively clean source, or with a major break in technique or significant spillage from an open viscous, or when acute non- purulent infection is encountered. Class IV (dirty) wounds are frammatic wounds from a dirty source following delayed treatment or when acute bacterial contamination and releases of pus occur.

Micro organism of clinical importance can be isolated from wounds and they include Achinomyces species. Bacteriodes species, clostridium perfringes, Eschericha coli, other gram negative enteric bacilli, my cobacterium species, pseudomonas aerug, nwa proteus vulgaaris, staphlococcus aureus. Stapholococcus epidermis stretococcus faecalis, clostridium fetani (Fischachi, 1987)

Wound sepis depends on the opportunities for infection in different parts of the body which in turn depends on the normal bacteria flora of the part, the size of the wound, duration of the operation increase in the length of stay in the hospital and can even result in patients death