A STUDY ON BACTERIAL ISOLATES AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN PATIENTS WITH COMPOUND FRACTURE WOUNDS IN A TERTIARY CARE HOSPITAL
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
Full Text:
PDFReferences
Hauser CJ, Adams CA JR, Eachempati
SR. Council of the Surgical InfectionSociety.
(2006).Surgical infection society guideline:
prophylactic antibiotic use in openfractures:
an evidence-based guideline. Surg. Infect.
(Larchmt);7: 379-405.
Zalavras CG, Marcus RE, Levin LS, Patzakis
MJ. (2007). Management of openfractures
and subsequent complications. J.
Bone Joint Surg. Am; 89: 884-95. 5)
Anglen JO. (2005). Comparison of soap
and antibiotic solutions for irrigation oflowerlimb
open fracture wounds. A prospective,
randomized study. J. Bone Joint Surg.Am;
: 1415-228)
Cat T, Hall L. (2007). Trauma: Antibiotics
in open fractures. Hosp Pharm. 42;413-416.
Soontornvipart K, Necas A, Dvorak M
(2003). Effects of metallic implant on therisk
of bacterial osteomyelitis in small animals.
Acta Vet. Brno; 72: 235-47
Gustilo RB , Anderson JT (1976). Prevention
of infection in the treatment of onethousand
and twenty-five open fractures of long
bones: retrospective and prospectiveanalyses.
J. Bone Joint Surg. Am; 58:453-8.
Okike K, Bhattacharyya T (2006).
Trends in the management of open
fractures.A critical analysis. J. Bone
Joint Surg. Am; 88: 2739-48.
Lee J (1997). Efficacy of cultures
in the management of open fractures.
Clin.Orthop. Relat. Res; 339: 71-75.
Levine NS, Lindberg RB, Mason
AD Jr, Pruitt BA Jr. (1976). The
quantitativeswab culture and smear:
A quick, simple method for determining
the number of viableaerobic bacteria
on open wounds. J Trauma;
:89-94.
Howell-Jones RS, Wilson MJ, Hill
KE, Howard AJ, Price PE, Thomas
DW.(2005). A review of the microbiology,
antibiotic usage and resistance
in chronic skinwounds. J Antimicrob
Chemother; 55:143-9.
Gardner SE, Frantz R, Hillis SL,
Park H, Scherubel M. (2007). Diagnostic
validityof semiquantitative
swab cultures. Wounds; 19:31-8.
Cheesbrough M. Medical laboratory
manual for tropical countries II.
: 255- 75.
Clinical and Laboratory Standards Institute.
Performance standards forantimicrobial
disk susceptibility tests; Approved
Standard—Ninth Edition. Clinical and-
Laboratory Standards Institute document
M2-A9 [ISBN 1-56238-586-0]. Clinical
andLaboratory Standards Institute, 940
West Valley Road, Suite 1400,
Wayne,Pennsylvania 19087-1898 USA,
Fakoor M, Pipelzadeh MH (2007). A
study on the healing effect of honey oninfected
open fracture wounds. Pak. J.
Med. Sci; 23: 327-9.
Azam Q, Sherwani M, Abbas M,
Gupta R, Asif N, Sabir AB. (2007). Internalfixation
in compound type III fractures
presenting after golden period. Indian J
Orthop;41:204-8.
Osman M, Kebede Y, Anberbir S
(2003). Magnitude and pattern of injuries
innorth Gondar administrative zone, North
West Ethiopia. Ethio. Med. J; 41: 213-20.
Ikem IC, Oginni LM, Bamgboye EA,
Ako-Nai AK, Onipade AO (2004). Thebacteriology
of open fractures in Ile-Ife,
Nigeria. Niger J. Med; 13: 359-65.
Johnson EN, Burns TC, Hayda RA,
Hospenthal DR, Murray CK.
(2007).Infectious complications of open
type III tibial fractures among combat
casualities. ClinInfect Dis; 45:409-15.
Patzakis MJ, Harvey JP, Ivler D.
(1974). The Role of antibiotics in themanagement
of open fractures. J. Bone Joint
Surg. Am; 56:532-41.
Dhawan B, Mohanty S, Das BK,
Kapil A. (2005). Bacteriology of orthopaedicwound
infections in an Indian
Tertiary Care Hospital. Indian J Med
Res; 121:784-5.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
An Initiative of The Tamil Nadu Dr M.G.R. Medical University