Bacterial pathogens prevalent amongst orthopaedic patients in New Delhi

Abstract

Background: The problem of changes in pathogenic microbiological flora and the emergence of bacterial resistance have created major problems in the management of orthopaedic diseases and fractures. We, therefore, have conducted this study to find out the frequency of bacterial flora in relation to the different clinical syndromes and the antibiotic sensitivity pattern of various bacterial isolates and thus guide the empirical antimicrobial chemotherapy in orthopaedic wound infections. Materials and Methods: A retrospective study of the bacterial isolates of pus specimen collected from orthopaedic patients who had various clinical diagnoses was carried out at the Routine Laboratory of Department of Microbiology. The culture and antimicrobial susceptibility patterns were reviewed for the period 2007 through 2012. Results: During the six year study period from 1 st Jan 2007 to 31 st Dec 2012, our laboratory received a total of 1722 specimens of pus whose site of sample collection included open fractures, bed sores, surgical site infection (SSI), synovial fluid and pin tract site infections. Of these, 900 (52.26%) specimens showed culture positivity including 62 specimens yielding >1 organisms, 822 specimens (47.73%) did not show growth of any pathogenic organism after 48 hours of aerobic incubation. The isolation rate of gram positive and gram negative organisms from various clinical syndromes was roughly similar. Most of the gram positive organisms were sensitive to Cefazolin and most of the gram negative organisms to Amikacin. Conclusions: We recommend the combined use of Amikacin and Cefazolin as the first drugs of choice for empirical therapy in orthopaedic patients with wound infections.