Evaluation of Aerobic Bacterial Isolates and its Drug Susceptibility Pattern in Orthopaedic Infections

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Evaluation of Aerobic Bacterial Isolates and its Drug Susceptibility Pattern in Orthopaedic Infections

Journal Title: Journal of Medical Science And clinical Research - Year 2014, Vol 2, Issue 6

Abstract

Orthopaedic infections are associated with a high morbidity, often require an aggressive antibiotic therapy, so increased substantial cost. Bone infections remains a serious therapeutic challenge and and increasing resistance has complicated management of these infections. Delayed or ineffective treatment causes significant morbidity in terms of pain, loss of function and the need for further surgery and antibiotics. Objective: To study the aerobic bacteriological spectrum and antibiotic susceptibility pattern of isolates of orthopaedic infections Materials And Methods: We performed a retrospective review of clinical and microbiological data sets using the access database of patients admitted in orthopedic ward for one year. Results: Out of 98 samples, 72(73.46%) yielded pure growth, 21(21.42%) mixed growth, 5(5.1%) showed no growth. Out of 115 bacterial strains isolated 56(48.69%) were Staphylococci and 59(51.3%) were Gram negative bacilli. Among the Staphylococcus spp, MRSA(50%), MSSA(33.9%), MSCONS (9%) and MRCONS(7.1%). Susceptibility pattern of MRSA isolates were 68% to cotrimaxozole, 43% to clindamycin,29% to erythromycin, 18% to gentamycin and all MRSA strains were sensitive to Vancomycin and Linezolid. Among Gram negative bacilli, Pseudomonas(25.4%), Escherichia coli(22%), Enterobacter (22%), Klebsiella (15.3%), Citrobacter (8.4%), Acinetobacter (3.3%) and Proteus (3.3%). Pseudomonas strains showed100% Vishwajith et al JMSCR Volume 2 Issue 6 June 2014 Page 1257 JMSCR Volume||2||Issue||6||Page 1256-1262||June 2014 2014 INTRODUCTION The problem of changes in pathogenic microbiological flora and the emergence of bacterial resistance has created major problems in the management of orthopaedic diseases and fractures. Due to the use of implants for open reduction and internal fixation, which are foreign bodies to the body, orthopaedic trauma surgery is at grave risk of microbiological contamination and infection[1]. The pathogenesis of infection in fractures, fixation devices is related to microorganisms, which grow in biofilm, and therefore its eradication is difficult[2]. In human the most common route by which bacteria reach the bone is blood stream[3],[4]. However, traumatic modes as penetrating injury[5], fractures and intra-medullary nailing[6], implants and postsurgical complications[7] have been identified. Intravenous drug users[8],[9] and the presence of foreign body[10] also predispose to bone infection. The various factors influence the nature and frequency of infection like low resistance of patients, contact with infectious persons, contaminated environmental sites and drug resistance of endemic organisms[11]. The source of an infecting organism may be present in patients body i.e. endogenous or exogenous in which organisms may be from another patient or a member of the hospital staff or from the inanimate environment of the hospital. The environmental sources like air, water, food, medication, equipment/instrumentation, soiled linen, hospital waste and contamination of wounds during the time of injury by dirt, soot, grease etc. play an important role in orthopaedic infections[1]. During the past few years, there has been remarkable improvement in the field of diagnosis of infection due to newer techniques, better health care systems, increasing awareness of patients; and invention of newer, more effective, and less toxic antimicrobials for combating osteo-articular infections[1].Orthopaedic wound infections are difficult to treat or eradicate completely in the absence of early diagnosis and prompt treatment or failure of antibiotic therapy due to development of drug resistance, these infections are still an important cause of high morbidity. Proper management requires accurate microbial isolation and appropriate antibiotic administration. Keeping this in mind we decided to evaluate the data to know the aerobic bacterial etiological agents sensitivity to imipenem, 87% to piperacillin-tazobactum,73% to amikacin,66% to cefotaxime,47% to ciprofloxacin,27% to gentamycin. Conclusion: Knowing the prevalence and the antibiotic susceptibility pattern of the isolates, helps us to guide the clinician to select the most appropriate antibiotics thereby preventing indiscriminate use of antibiotics.

Authors and Affiliations

Anuradha. K

Keywords

orthopaedic infection antibiotics drug resistance MRSA Gram negative bacilli

EP ID EP205933
DOI -
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