Pathogen identification in 84 Patients with post-traumatic osteomyelitis after limb fractures

Area of Science:

• Orthopedics and Traumatology
• Infectious Diseases
• Microbiology

Background:

• Chronic osteomyelitis is a severe complication of orthopedic trauma, often prolonged by antibiotic resistance and biofilm formation.
• Identifying bacterial isolates is key for developing passive immunotherapies against bone infections.
• Timely and dynamic epidemiological data on pathogens are lacking for effective clinical treatment.

Purpose of the Study:

• To analyze the incidence, infection sites, and pathogen distribution of post-traumatic osteomyelitis (PTO).
• To determine the antibiotic susceptibility patterns of common bacterial strains causing PTO.
• To provide epidemiological data for guiding clinical treatment strategies.

Main Methods:

• Retrospective analysis of 5,268 limb fracture patients treated between 2012 and 2015.
• Diagnosis of PTO based on clinical, imaging, and pathological findings in 108 patients.
• Bacterial culture, pathogen identification, and antibiotic susceptibility testing using CLSI M-100-S22 protocol.

Main Results:

• PTO incidence was 2.1% (108/5,268), with positive bacterial cultures in 77.8% (84/108) of cases.
• The lower extremity, particularly the tibia and fibula (47.6%), was the most common infection site.
• Staphylococcus aureus (37.5%) was the dominant Gram-positive pathogen, and Escherichia coli (15.4%) was the most common Gram-negative pathogen.

Conclusions:

• The incidence of PTO in the Zunyi area aligns with national levels, with lower extremities being most affected.
• Staphylococcus aureus, Escherichia coli, and Enterobacter cloacae are key pathogens in PTO.
• Antibiotic resistance patterns vary regionally, necessitating tailored treatment approaches.