Bacterial infection and antibiotic resistance pattern in open fracture cases in Indonesia

The annual incidence of open fracture in Dr Soetomo Hospital, East Java were 400 cases with chronic infection complications exist in 14% (57 cases). A previous study in this hospital shows the resistance rate of Pseudomonas towards cefazolin and amikacin was 100% and 15%, respectively. The objective of this study was to identify bacterial infection type and antibiotic resistance pattern in infection caused by the open fracture.

This was an analytic cross-sectional study. Samples were collected from three debridement surgery sites in Mataram Hospital, Mataram University Hospital, and Islamic Mataram Hospital from September 2019 until October 2020. Specimens from wound infection were cultured, and an antibiotic sensitivity test was performed.

Approximately 213 samples were analyzed in this study, comprising open fracture grade 3A (45%) and 3B (39%). The majority of fractures were lower extremity fractures (62%). Bacterial infection were found in 35% cases (80 isolates) in which 62,5% (50 isolates) were gram-positive bacteria and 37,5% (30 isolates) were gram-negative bacteria. Infection in open fracture was equivalent to grading. The predominant bacterial infection was caused by gram-positive bacteria, including Staphylococcus aureus and Staphylococcus negative coagulase. Gram-positive bacteria were sensitive towards Cepoferazone, Sulbactam and Ofloxacin, whereas gram-negative bacteria remains sensitive against Doxicyclin and Amicasin.

Infection in open fracture was equivalent with the grade, and gram-positive were predominantly sensitive with cefoperazone sulbactam.