Abstract
Background: Post operative infections in orthopedic implants is a major problem in orthopedic patients nowadays which can lead to implant failure and in severe cases can even lead to amputation and mortality.These are mainly associated with Open reduction and internal fixation (ORIF) of fractures with implants and prosthesis which has become the first line in the management of fractures in most traumacentres in recent times. This is also associated with high morbidity and cost for patient during his hospital stay.
Objectives: The objective of this paper is to isolate and identify the bacteriological isolates responsible and their antimicrobial sensitivity from post-operative orthopedic implant infections.
Materials and Methods: This was a prospective study carried out at a tertiary care hospital in India over a period of six months. The study was conducted on 50 cases of infected implants from orthopaedic wards, admitted in DR.B.R Ambedkar Medical College, Bangalore from 1stJuly to 1st December 2016.Pus samples were collected using two sterile swabs .One is used for Grams stain and other for inoculation on Mac conkey and blood agar. Susceptibility testing was performed by Kirby-Bauer disk diffusion technique.
Results: Out of the 50 samples processed, 40 (80%) of specimens showed culture positivity. Staphylococcus aureus 14(35%) was the predominant isolate followed by Escherichia coli 10(25%),Klebsiellaspp 8(20%), Pseudomonasspp 5(12.5%),Acinetobacterspp2(5%) and Proteus spp1 (2.5%). All Gram-positive cocci were susceptible to vancomycin and linezolid.
Gram negative bacilli were resistant to ceftriaxone (84.6%), ciprofloxacin(69.2%), cotrimoxazole (69.2%)and sensitive to carbapenems and piperaciillintazobactam. ESBL production is seen in 11(61%) cases of Gram negative bacteria.
Pseudomonas isolates were susceptible to piperacillin-tazobactam, and meropenem.
Conclusion: Orthopedic implant post-operative infections are a major concern in the present scenario. There is an increase incidence of multidrug resistance among the pathogens isolated from these isolates. Adequate preventive measures should be taken to prevent these antibiotic resistance amongst organisms. In this study Gram Positive Organisms has emerged as major threat for orthopedic implants.
Key Words: Bacterial isolates; Antibiogram; Orthop edic infection; Wounds; ESBL.
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DOI: https://dx.doi.org/10.18535/jmscr/v5i4.64
