Aerobic Bacteriological Profile from Wound Site Infections in Road Traffic Accident (RTA) Patients

Abstract

Background: Infections of musculoskeletal injuries due to road traffic accidents, especially open fractures, continue to pose a challenge. There is limited information on the early bacterial contaminants of these wounds and their antibiotic sensitivity patterns in our environment. This study was done to determine the aerobic bacteriological profile of wound site infections in road traffic accident patients at initial presentation and their antibiotic susceptibility profile. The study was carried out over a one year period. Method: Discharge and swabs from the wounds of 247 patients presenting to the Casualty, KIMS Hospital were collected with aseptic precautions prior to the initiation of empiric antibiotic therapy. Gram stain, culture were performed and the isolates were subjected to antibiotic susceptibility testing by Kirby-Bauer disc diffusion method, as per CLSI guidelines. Results: Of the 247 samples studied, growth was observed in 232 samples of which 221 were monomicrobial and 11 were polymicrobial. A total of 273 bacterial isolates were recovered. Gram positive cocci constituted 40.3% and gram negative bacilli constituted 59.7% of the isolates. The most common pathogen isolated was Staphylococcus aureus followed by Pseudomonas spp. and Coagulase Negative Staphylococci. 36.5% of the Staphylococcus aureus isolates were found to be methicillin resistant. Conclusion: This study shows that Staphylococcus aureus and pseudomonas were the commonest organisms associated with the RTA wound site. A high rate of MRSA, MBL and ESBL producers was observed which imply treatment failure with empirical antibiotics. Hence the antibiotic susceptibility pattern of the isolated organisms should be obtained at the earliest to avoid unwarranted prolonged empirical therapy and to administer appropriate and effective treatment. Keywords: Bacterial, Bacterial infections, Injuries, Infection, Trauma, Wounds, Wound infections