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The Role of MDR-Acinetobacter baumannii in Orthopedic Surgical Site Infections
Sohier Helal1, Mervat El Anany1, Doaa Ghaith1
1Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt .
Background:
Gram-positive microorganisms were the main causative organisms of orthopedic surgical site infections (SSI); however the rising incidence of multiple drug resistant Acinetobacter baumannii (MDR-AB) infections in orthopedic operations causes a great concern because of their limited array of therapeutic options.
Objective:
Our objective was to remark the changing microbiology in orthopedic SSI and to evaluate the MDR CHROMagar Acinetobacter media for screening of MDR-AB.
Methods:
Aspirated pus samples were collected from infected wounds of 100 patients in the orthopedics unit of El-Helal Hospital, samples were cultured on conventional media and MDR CHROMagar Acinetobacter media, the reveled MDR-AB colonies were subjected to polymerase chain reaction (PCR) to detect blaOXA-51 like gene.
Results:
Out of 100 infected wounds SSI cases represented 90/100 (90%) according to CDC 2013 definitions. Staphylococcus aureus was the dominant organism 40/90 (44.4%) (P value 0.038), all S. aureus isolates were methicillin-resistant Staphylococcus aureus (MRSA), followed by Klebsiella pneumoniae 22/90 (24.44%) and Acinetobacter 15/90 (16.67%). Implant was highly associated with SSI cases 80/90 (89%). Also, prolonged hospital stay>7 d was significantly associated with SSI 69/90 (77%) (p=0.001).
Conclusion:
Staphylococcus aureus was the main causative organism of orthopedic SSI (44.4%), whereas A. baumannii represented only (16.67%) of the causative organisms. MDR Acinetobacter CHROMagar reduced the turnaround time for screening of MDR-AB.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of orthopedic surgical site infections (SSI), not Acinetobacter baumannii. MDR Acinetobacter CHROMagar media aids in faster screening of multi-drug resistant Acinetobacter baumannii.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedic Surgery
Background:
- Gram-positive bacteria are primary causes of orthopedic surgical site infections (SSI).
- Rising incidence of multidrug-resistant Acinetobacter baumannii (MDR-AB) poses a therapeutic challenge due to limited treatment options.
- Orthopedic SSI are often associated with implants and prolonged hospital stays.
Purpose of the Study:
- To identify the changing microbial landscape of orthopedic SSIs.
- To evaluate the efficacy of MDR CHROMagar Acinetobacter media for rapid screening of MDR-AB.
- To assess the prevalence of specific pathogens and associated risk factors in orthopedic SSIs.
Main Methods:
- Collected pus samples from 100 orthopedic patients with infected wounds.
- Utilized conventional media and MDR CHROMagar Acinetobacter media for bacterial culture.
- Employed Polymerase Chain Reaction (PCR) to detect the blaOXA-51-like gene in Acinetobacter baumannii isolates.
Main Results:
- Staphylococcus aureus was the dominant pathogen (44.4%), with all isolates being Methicillin-resistant Staphylococcus aureus (MRSA).
- Klebsiella pneumoniae (24.44%) and Acinetobacter species (16.67%) were also identified.
- MDR Acinetobacter CHROMagar media demonstrated a reduced turnaround time for MDR-AB screening.
Conclusions:
- Staphylococcus aureus, particularly MRSA, is the predominant cause of orthopedic SSIs.
- While Acinetobacter baumannii is a concern, it was less prevalent than S. aureus in this study.
- MDR Acinetobacter CHROMagar offers a valuable tool for expedited detection of MDR-AB in clinical settings.
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