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A STUDY ON BACTERIAL ISOLATES AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN PATIENTS WITH COMPOUND FRACTURE WOUNDS IN A TERTIARY CARE HOSPITAL

DEEPA NEDUMARAN

Abstract


Introduction Compound fractures (open
fractures) are those exposed to the outside
environment through a skin wound. In
India, Road Traffic Accidents forms the
single largest contributor of open fractures
with approximately 85,000 people being
killed every year and more than
1.2 million having serious limb injuries.
Aim To detect the bacterial profile and
evaluate their antimicrobial sensitivity pattern
in open fracture wound infections and
determine their resistance pattern
(Methicillin resistance and Extended spectrum
beta lactamase ESBL resistance pattern).
Materials and Methods This study
was done in patients with open fracture
wound infections. Pus samples were collected
from open fracture wounds using
sterile swab and processed by Gram staining
and aerobic bacterial methods. Antibiotic
susceptibility testing was done by disc
diffusion method (Kirby Bauer method) on
Mueller Hinton agar. Results Out of 200
samples, 161 samples were culture positive.
134 (67 percent)
isolates were monomicrobial , 27 (13.5
percent) isolates were of polymicrobial
growth and 39 (19.5 percent) isolates
showed no growth. Totally, 188 isolates
were obtained from 161 culture positive
cases. Staphylococcus aureus (26.06
percent) was the predominant pathogen
from open fracture wound infection followed
by Staphylococcus epidermidis
(21.8 percent) and Proteus mirabilis
(14.39 percent). Out of 49 S. aureus and
41 S.epidermidis isolates 22 (44.8 percent)
and 19 (46.34 percent) were detected
as Methicillin resistant respectively.
Out of 98 GNB isolated, 62
(63.3percent) showed ESBL resistant pattern.
The GPC isolated were 100 percent
sensitive to Vancomycin and 83.05 percent
sensitive to Amikacin. The GNB isolates
were sensitive to Imipenem (100
percent), Cefoperazone-sulbactum
(83.33percent ), Ciprofloxacin (77.33 percent)
and Gentamicin (71 percent). Conclusion
This study revealed Staphylococcus
aureus as the predominant bacterial
pathogen from open fracture wound


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