Pathogenic bacteria in an orthopaedic hospital in India

The problem of changes in pathogenic microbiological flora and the emergence of bacterial resistance has created major problems in the management of orthopaedic diseases and fractures. Due to the use of implants for open reduction and internal fixation, which are foreign bodies to the body, orthopaedic trauma surgery is at grave risk of microbiological contamination and infection.

With new microbiological agents in vogue, we have conducted a retrospective study to determine the pattern of bacterial infection, sensitivity to various antimicrobial agents, and their relations to various orthopaedic illnesses and procedures.

Gram negative (E. coli and Pseudomonas spp.) infections have emerged as the major threat (74.37%) in orthopaedic cases in contrast to Staphylococcus aureus (23.31%). These bacteria infected patients with open fractures (34.3%), spinal instrumentation with bedsores (23.31%), osteomyelitis of bone (24.42%) and guillotine amputation stumps (14.43%).

Cefaperazone and ceftriaxone were found to be the most effective antibiotics against gram negative bacteria while cefaperazone was equally effective against S. aureus. Emerging resistance was found against amoxicillin, ampicillin and the aminoglycoside: amikacin.