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Microbiological Profile and Drug Resistance Analysis of Postoperative Infections following Orthopedic Surgery: A
Zuhdi O Elifranji1, Bassem Haddad1, Anas Salameh1
1Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman, Jordan.
Background:
The distribution of postoperative orthopedic infection and their susceptibility pattern to antibiotics vary regionally and change over time. The incidence of methicillin-resistant Staphylococcus aureus infection is rising worldwide. Therefore, knowledge of the frequency of the causative microorganisms and their susceptibility to antibiotics are necessary for an improved therapeutic outcome. This study aims to study the frequency and distribution of postoperative orthopedic infection and their resistance pattern to antibiotics.
Methods:
The study utilized a retrospective design that took place over a period of 5 years from 2016 and 2020 at a tertiary care hospital. The bacterial culture testing was performed by a recommended method. Descriptive statistics were used to analyze the data.
Results:
A total of 158 patients (100 males and 58 females) with positive cultures of postoperative orthopedic infection were included. The most common infective organism was Staphylococcus aureus, 64 patients (38.1%); coagulase-negative staphylococci, 40 patients (23.8%); Klebsiella species, 14 patients (8.3%); and Enterococcus species, Escherichia coli, and Pseudomonas aeruginosa in 10 patients (6%). Data also showed that gram-positive bacteria were detected in 118 patients (70.8%), while gram-negative microorganisms were found in 50 patients (29.8%). Among Staphylococcus aureus, 79.7% were MRSA, and vancomycin was the most effective antibiotic in staphylococcus infections. The antibiotics with the greatest sensitivity to gram-positive bacteria were vancomycin, linezolid, tigecycline, moxifloxacin, and nitrofurantoin, while the antibiotics for gram-negative bacteria with greater sensitivity were tigecycline, amikacin, ertapenem, imipenem, and cefotaxime.
Conclusion:
Staphylococcus aureus is the most common postoperative orthopedic infection, which was predominantly MRSA with vancomycin being the most effective antibiotic. In addition, the results showed a high resistance pattern to the commonly used antibiotics, leaving few choices. Antibiotic agents should be carefully selected according to specific drug sensitivity through routine monitoring of drug resistance patterns and to help formulate hospital antibiotic policy.
Insights
Staphylococcus aureus, predominantly MRSA, is the most common cause of orthopedic infections. Vancomycin is effective, but high resistance to common antibiotics necessitates careful drug selection based on sensitivity testing.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Microbiology
Background:
- Postoperative orthopedic infection patterns and antibiotic susceptibility vary regionally and over time.
- Rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections globally.
- Understanding causative microorganisms and antibiotic susceptibility is crucial for effective treatment.
Purpose of the Study:
- To investigate the frequency and distribution of postoperative orthopedic infections.
- To determine the antibiotic resistance patterns of causative microorganisms.
Main Methods:
- Retrospective study conducted over 5 years (2016-2020) at a tertiary care hospital.
- Bacterial culture testing performed using recommended methods.
- Descriptive statistics used for data analysis.
Main Results:
- Staphylococcus aureus was the most common organism (38.1%), with 79.7% identified as MRSA.
- Gram-positive bacteria (70.8%) were more prevalent than gram-negative (29.8%).
- Vancomycin showed effectiveness against Staphylococcus infections; other effective antibiotics included vancomycin, linezolid, tigecycline for gram-positive, and tigecycline, amikacin for gram-negative bacteria.
Conclusions:
- Staphylococcus aureus, particularly MRSA, is the leading cause of postoperative orthopedic infections.
- High resistance to common antibiotics was observed, limiting treatment options.
- Careful antibiotic selection based on drug sensitivity and routine resistance monitoring is essential for hospital antibiotic policies.
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