Organisms Causing Postoperative Implant Infection in Orthopedic Patients Presenting at a Tertiary Care Hospital.

Abstract

Introduction Infections pose a significant challenge in orthopedics related to implant failure. In orthopedic surgeries, surgical site infections (SSIs) extend the patient's hospital stay by an average of two weeks and also increase morbidity, double hospitalization rates, and triple the financial burden on the patient. This study aims to determine the common organism in patients with postoperative implant infections presenting at a tertiary care hospital. Methods A cross-sectional study was conducted in the Department of Orthopedic Surgery at JPMC Karachi over a six-month period, from November 24, 2022, to May 25, 2023. All patients of both genders aged 18-65 years presenting with postoperative implant infection within six hours of the development of symptoms were enrolled. Baseline demographic details and clinical histories were recorded at the time of presentation. A swab for culture and sensitivity was taken from the implant site using a sterile swab stick in patients with confirmed or suspected infections. Results Of 196 patients, the mean age of the patients was 48.47±5.19 years. Gender distribution showed that 49% of patients were females and 51% were males. The mean duration of surgery was 1.71±0.49 hours (100 minutes approximately);Klebsiella species 26% and Staphylococcus aureus25.5% were the most common organisms isolated from infected surgical wounds, followed by Pseudomonas species in 32 patients (16.3%), Acinetobacter species in 27 patients (13.8%), Escherichia Coliin 23 patients (11.7%), and coagulase-negativeStaphylococcusin 13 patients (6.6%). Conclusion In our cohort, Staphylococcus species and Klebsiella species were the most common pathogens isolated from postoperative implant infections. The rise in Klebsiella species suggests that changes in prophylactic antibiotic practices may have contributed to this trend. Therefore, there is an urgent need to reassess current prophylactic strategies in light of the increasing incidence of infections caused by gram-negative bacteria.