Introduction

Wound infection has been defined as wound with pus visible to the necked eye, whether or not organisms could be cultured from the purulent material. (Maki, 1983)

Open injuries whether caused a laceration, a crash injury or a penetrating missile wound have three facets in common and differ only in a matter of degree. All are considered to be primarily contaminated by microorganisms, all may contain foreign babies and all are likely to contain a significant amount of devitalized or necrotic tissue. (Bellcham bears, et al, 1999)

The most likely organisms to infect clean operation wounds in hospital are Staph. Aureus, ps. aerugionsa, and E.coli, as with accidental wounds local treatment often sufficient. (Jibran, 1986).

If infection is deep- seated or becomes generalized appropriate systemic treatment must be administered. (murthy, etal.,1998)

In addition, the entry site should be cleansed daily and treated with one of the antiseptics such as centaulon, Hibitane, and quinolines. (Kiernan, 1998)

A vast amount of work has done over the post 50 years in attempts to explain the infection that can follow “clean” surgical operation, but still no complete satisfactory solution (s) has been documented. There is still uncertainly as to how often a wound is infected in the operating room, and how often at a later data during the healing of the wound. (loncl south, 1999) Murthy, etal., 1998.

There are those who deny that air in the operating theatre is an important source of infection because bacterial pathogens from only a minute fraction of colonies grown from the air. In the ward, on the other hand, the aerial route for post-operative cross-infection is regarded as a potent one.(Allababidi and Shah, 1998, From, etal, 1996).

The present study aimed to Isolate the major bacterial types associated with post operation infected wounds, evaluate the efficacy of four disinfectants on the major bacterial types, and evaluation the effects of plant extracts of Myrtus communis, Eucalyptus, and Nerium oleander on the types of bacteria , in comparison with the standard antibiotics .

Materials and Methods

Post-operative wounds

Bacteriology Study

Disinfectants

Plant extracts

Antibiotics

Evaluation of the antibacterial activity

Results

Presence percentage of major bacterial types are showed in Table-2- from 40 bases, 29 cases (72.5%) yielded positive culture results, while II cases (27.5%) are negative cultured cases (no growth).

From positive cases: the following types of bacteria and their percentages may show:

Staph. aureus and Pseudomonas (22 cases 75.86%) Staph. epidermidis (16 cases 65.16%). E.cdil (14 cases 48.27%)

β-hemolytic streptococci (13 cases (44.82%))

α- hemolytic streptococci (10 cases 34.48%))

Klebsiella (8 cases 27.58)

And Proteus (6 cases 20.68)

Total number of isolated (106) bacterial types from all positive cases.

Result of Antibacterial activity of disinfectants, plant extracts and antibiotics determine by Agar diffusion (plate) method (Determine growth inhibition zones (mm) are listed below:

The greatest effects are for 100% concentration of all disinfectants and for meg/ml of plant extracts while most others 50% of disinfectants and 100 meg/ml of extracts are not effective of the genera of bacteria. We can summarized the biggest inhibition zones as follow:

(8,10,8,6, NE,12,10,12) mm for 100% Septol.

(10,12,10,NE,8,12,11,10) mm for 100% Iodine.

(16,15,8,11,9,12,10)mm for 100% Savlon.

(20,15,14,13,15,12,11,14) mm for 1000 mcg/ ml for extract of Eucalyptus

(12,11,13,9,12,11,12,11)mm for 100 cimeg/ml for extract of Myrtus communis

(18,20,14,11,13,10,12,11)mm for 100 mcg/ml for extract of Nerium oleander on growth of E coli, Klebsiella, Proteus, pseudomonas, Staph aureus, Staph. Epidermidis, α--hemolytic streptococci, and β-hemolytic streptococci respectively.

In comparison with standard antibiotics, the ranges inhibition zones are between 10-30 mm, while some antibiotics are not effective some bacterial types.

Figure 1

Table –1- types and concentrations of disinfectants used in study

Figure 2

Table –2- Percentage of bacterial types isolated from post-operative wounds (40 cases)

Discussion

Our result revealed a highly infected percentages of post-operative wounds with a many bacterial types, only 11 cases 27.5% are negative cultured, these facts may indicate a high contamination of post operative wound with aerobic and anaerobic bacteria depend on many factors, such as careless of patents, poor nursing services, highly diluted disinfectants, contamination of surgical instruments, contamination of theater room, not give a suitable antibiotics in treat a infected post operative wound and other factors. (platt and page, 1995, Sana, etal,1995)

The problem of hospital infection is a real one. Antibiotic-resistant Staph.aureus and various Gram- negative bacilli-inespecially. Pseudomonas have played a predominant role. (Frohm, etal, 1996)

Self-infection (endogenous) may be due to bacteria causing infection (e.g. from boils) or carried by the patients without any systems on the skin, in the nose, mouth, or in the intestinal tact. (Blair, et al, 1995)

Cross-infection and infection from the environment (exogenous may occur with organisms transferred from patients or members of staff by contact or via airborne routs. Infection may be transferred on hands, or clothing of staff, visitors, or ambulant patients, on inadequately sterilized instruments, on fomites or in fluids (e.g. Ps. aeroginosa in cetrimide containing disinfectant) etc. (Bellchambers, etal, 1999, Russel,etal, 1982)

Also many another studies such as Lan and south, 1999, Kiernan, 1998, Murthy,etal, 1998) show that nurses, doctors and others who attend to many patients can transfer infective organisms from one patient to another, visitors may transfer their own microorganisms. Airborne transfer may occur through the dispersal of minute skin scales or minute droplets from the mouth, wound dressings dust or nebulisers serves as a potential source of airborne infection.

Disinfection solutions contaminated with Gram negative bacilli are a particular hazard in hospital and infections originating from them have been reported (Russell, etal, 1982)

Contamination is usually due to inappropriate disinfectants, the use of weak solutions, or “topping up” of containers (Jibran, 1986)

Our study approved results of above and other studies, we found that many disinfectants in 50% of dilution and some of concentrated solution 100% are not effective against some bacterial types.

The hospital staff responsible for buying and using environmental disinfectants are often poorly trained in control of infection techniques and have little knowledge of microbiology. All disinfectants are more or less equally effective, irrespective of concentration, and no bacteria will survive in a disinfectants solution. If a surface is treated with a disinfectants, bacteria will continue to be killed even after the surface has dried. (Frohm, etal, 1996, Blair, 1995, Russell, 1982)

Extracts of Myrtus Commanis, Eucalyptus, and Neriam oleander give a useful effects on bacterial types, these may be due to a highly concentrated antibacterial agents present in these plants, therefore, some of them used in Arabic medicine for treating of many infections diseases, but little acknowledge or information available in word about antibacterial properties of these extracts. So, some of them using in mummification, preservation, and other important process, such as in Egyptian civilization employed variety of balsams, camphoroil, which contained natural preservative. Natron, a crude of native sodium carbonate, was also used to preserve the bodies of human and animal alike, also wine, vinegar and honey were used on dressing and as cleansing agents for wounds, and it is interesting to note that diluted acetic acid has been recommended comparatively recently for the topical treatment of wound and surgical lesions infected by Pseudomonas aeraginesa and Staph. aureas.(Al-waili and Saloom,1999, Alababidi and Shah, 1998, Saha, et al, 1995)