BACTERIOLOGICAL PROFILE AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ORTHOPAEDIC IMPLANT RELATED INFECTIONS IN A TERTIARY CARE HOSPITAL

Abstract

Background - Orthopaedic implant infections are considered to be the most devastating complications leading to prolonged hospitalization, repeated surgical interventions and even definitive loss of the implant and limb. Aims and  Objectives- To detect the prevalence of common bacterial    isolates and their antimicrobial susceptibility and resistance pattern in Orthopaedic implant associated infections.   Methodology - Out of 920 cases undergone Orthopaedic implant surgery , pus samples were collected from 184 patients with infected implant wound during the period of Jan2014 to June 2014 .Those samples were processed and bacterial pathogens were identified by standard Microbiological methods. Their  antimicrobial susceptibility pattern, MRSA and ESBL detection were performed by Disc diffusion method. Results - Among 184 patients enrolled in this study, 152 (82.6 percent) were males and 32 (17.4 percent) were females. Most of them in the age group of 26-40 years (63.6 percent). Out of 184 samples           processed, 169 (91.8 percent) samples showed single bacterial isolate and 7(3.8 percent) samples showed polymicrobial growth. Implant infections were more common in fractures of leg and foot accounting to 53.8 percent. Staphylococcus aureus 44 (25 percent) was the predominant pathogen isolated followed by Klebsiella species 38 (21.6 percent). Most of the Gram positive and Gram negative bacteria were susceptible to Amoxy-clav or Piperacillin- Tazobactum, Gentamicin or Amikacin, Ofloxacin, Ceftazidime and Vancomycin. 40.9 percent of Staphylococcus aureus and 28 percent CoNS were methicillin resistant. 9 (23.7 percent) Klebsiella species, 7 (24 percent) Proteus species and 2 (20 percent) Escherichia coli were ESBL producer. None of the isolates in this study showed resistance to multiple  antibiotics. Conclusion- In Orthopaedic implant infections, knowledge of the commonly isolated organisms and their            antimicrobial susceptibility pattern within our hospital assists in the selection of appropriate antimicrobial treatment.