Bacterial flora and their antibiotic susceptibility patterns in open fracture wounds at a tertiary hospital of north India
Journal Title: Medpulse International Journal of Orthopedics - Year 2018, Vol 5, Issue 3
Abstract
The changes in pathogenic microbiological flora and the emergence of bacterial resistance have created major problems in the management of open fractures. A better understanding is required of the patterns or predilection of organisms and thus anticipating infection by a particular organism. Hundred and seven open fractures wounds of long bones were studied prospectively over a period of one year. Wound swabs were obtained and sent for cultures at regular intervals i.e.; at Pre-debridement, intra-operative, post debridement, at first dressing and then every week. The infecting organism and its antibiotic susceptibility were noted. Most of the infections were caused by Gram-negative organisms 64.7%, commonest being Pseudomonasspp (36%) which was resistant to most antibiotics and showed maximum sensitivity to piperacillin (85%).A shift in the bacterial flora was noted after the 2nd week from Gram-negative to predominantly Grampositive organisms. Among the Gram-positive organisms, 93.5% were Staphylococcus aureus, 58.6% of which were methicillin resistant. Use of a broad spectrum antibiotic during the initial phase of management could prevent a change in the bacterial flora in later stages and thus decreasing chances of bacterial resistance. However the final selection of antibiotic should be tailored according to the type of fracture, level of contamination, soft tissue status, and most importantly the prevailing infection and culture sensitivity patterns in the hospital.
Authors and Affiliations
Shiraz M Bhatty, Kapil Bansal, Anshul Dahuja, Rajesh Paul
Keywords
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