Microbiology of amputation wound infection in a Nigerian setting

To identify the microbial pathogens responsible for amputation wound infections, their distribution and antibiotic-sensitivity patterns.

Consecutive patients who had limb amputations from April 2002 to March 2006 in an Nigerian hospital were recruited into this prospective observational study. The patients' demographic features, indications for amputation, microbiology of stump wound infections and the effects on length of hospital stay were reported.

Fifty-seven patients (mean age 34.6 +/- 19.2 years) had amputations in 58 limbs. Trauma leading to limb gangrene following treatment by traditional bone setters was the most common indication for amputation (64%). Approximately 76% of the amputations were in the lower limbs. Wound infection occurred in 48% of the stumps, of which 71% had been amputated because of a trauma injury. Pseudomonas aeruginosa was the most commonly isolated pathogen (40%).There was a very low correlation between the aetiologic bacterial agents and the age of patient, source of referral, indication for amputation and level of amputation. Amputation wound infections significantly prolonged the patients' length of hospital stay (p=0.002).

Amputation wound infection constitutes a serious morbidity in our practice. Most of the causes are preventable.