A study on the microbial profile at surgical site with orthopedic implant in traumatic injuries and its associated risk factors at tertiary care hospital

Abstract

Introduction: Study was conducted to identify the etiological agents of orthopedic implant infections in posttraumatic postoperative period. To identify the risk factors for orthopedic implant infection. To study the Antimicrobial susceptibility patterns of the isolates with a view to formulate an empiric antibiotic regimen.Material and Methods: The study period was prospective study conducted January 2020 to December 2021. One hundred and fifty patients were investigated for early, intermediate and late post-operative infections of orthopedic bone implants using conventional microbiological procedures. Antimicrobial susceptibility testing was then performed for the isolated bacteria according to the standard guidelines.Results: Out of 150 orthopedic post traumatic, postoperative implant infections, a total of 140 isolates had positive culture (138 aerobes and 2 anaerobes). Of the total 150 cases 80.66 % was mono microbial infection whereas 12.6% had poly microbial. Staphylococcus aureus is the most common organism isolated followed by Pseudomonas and E.coli. 60.2 % of Staphylococcus aureus and 73.52% of Staphylococcus epidermidis were found to be methicillin resistant. 85 % Proteus and 67.2% of Escherichia coli were found to be Extended Spectrum Beta-Lactamases (ESBL) producers. 60% of staphylococcus showed sensitivity to Vancomycin and Rifampin, 76.78 %, 66.96%, 49.10%, 42.84%, 46.42% to Linid, Tiecoplanin, Clindamycin, Meropenum and to Imipenum respectively. Whereas 68.7% of Pseudomonas showed sensitivity to collistin, 56.25% and 53.12 to Piptaz/Tazobactum and tobramycin respectively. 70.2% of staphylococcus, 40% of Pseudomonas was sensitive to cephalosporins. Diabetes mellitus, compound injuries and longer duration of surgery were the important risk factors noted in our study. Diabetes was associated more with methicillin resistant Staphylococcus aureus. There was no difference found in sensitivity pattern in stainless steel and titanium implant.Conclusion: Prophylactic antibiotics should be started as per locally commonly observed organism and their sensitivity pattern to prevent infection.