Microbiological study of etiological pathogen in early infection of open fracture in orthopedics
PURPOSE: To evaluate the susceptibility of microorganism causing early infection in open fractures to current antibiotic prophylaxis and determine contributing factors towards development of resistance. METHODS: A total of 110 cases of open fractures were selected in this study. They underwe...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association
2019
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/74934/ http://irep.iium.edu.my/74934/ http://irep.iium.edu.my/74934/1/OPU06-etiological-pathogen-infection.pdf |
| Summary: | PURPOSE:
To evaluate the susceptibility of microorganism
causing early infection in open fractures to
current antibiotic prophylaxis and determine
contributing factors towards development of
resistance.
METHODS:
A total of 110 cases of open fractures were
selected in this study. They underwent routine
debridement and C&S were followed up. Risk
factors to antibiotic resistance were identified.
RESULTS:
Admission to ICU, blood transfusion, antibiotic
regime and duration, fracture grade, injury
severity score and duration of admission were
significantly associated with resistance of
microorganism. There was Gram-negative
predominance of 65.9%. The overall resistance to
Cefuroxime was 68.6% and 36.9% to
Gentamicin. Staphyloccoccus aureus and MRSA
were the commonest Gram-positive while
Pseudomonas and Acinetobacter Gram-negative.
DISCUSSIONS:
Resistance in open fracture is not well
established unlike rate of infection. Previous
studies reported predominant Gram-postive
microorganisms which form the basis of
prophylactic antibiotics1
. Hannigan et al. reported
increasing multi-drug resistance bacterias in open
fractures2
. Carsenti-Etesse et al. reported
resistance was influenced by type and duration of
antibiotics while others have described various
other factors3
.
CONCLUSION:
The high resistance of microorganisms and shift
to predominantly Gram-negative microorganisms
is alarming. Further measures are needed to
achieve optimal outcome.
REFERENCES:
1. Gustilo, R.B., (1971). Management of
open fractures. An analysis of 673 cases.
Minnesota Medicine, 54(3), pp.185–189
2. Hannigan, G.D. et al., 2014. Cultureindependent pilot study of microbiota
colonizing open fractures and association.
Journal of Orthopaedic Research, 32( |
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