Microbial Profile and Antibiotic Sensitivity Patterns in Open Fractures: A Retrospective Study from a Tertiary Care...

Open fractures are orthopedic emergencies with a high risk of infection due to soft-tissue compromise and bone exposure. Early antibiotic administration and wound debridement are critical to reducing infection-related complications. However, microbial profiles and antibiotic sensitivity patterns vary regionally, warranting local evaluation.

This retrospective study was conducted over 24 months at a tertiary care center in North India. A total of 67 patients aged ≥18 years with open fractures were included. Wound swabs were obtained either within or after 6 h of injury and cultured using standard microbiological techniques. Antibiotic sensitivity was assessed by the Kirby-Bauer disc diffusion method (Clinical and Laboratory Standards Institute 2023). Data were analyzed using the Statistical Package for the Social Sciences v21.0, with P < 0.05 considered significant.

The mean age of patients was 36.75 ± 14.5 years; 71.6% were males. The most common fracture site was tibia-fibula (40.3%), followed by femur (16.4%). Type IIIB fractures were most frequent (32.8%). Overall culture positivity was 28.4%, with Staphylococcus aureus (36.8%) as the predominant isolate, followed by Actinobacter spp. (26.3%) and Escherichia coli (10.5%). Infection rates were significantly higher when swabs were taken after 6 h of injury (58.3% vs. 21.8%, P = 0.011). Diabetes mellitus was associated with a greater infection risk. Doxycycline demonstrated the highest antibiotic sensitivity (57.9%) and cost-effectiveness, followed by amikacin and linezolid (52.6% each).

The infection rate in open fractures was 28.4%, predominantly caused by S. aureus. Delayed wound sampling and diabetes were major contributors to infection. Doxycycline emerged as the most effective and economical antibiotic. Early wound sampling and prompt antibiotic coverage within 6 h are essential to minimize infection risk and optimize outcomes.