Common Pathogen Frequency And Antimicrobial Sensitivity Pattern In Open Fractures Of The Extremities

Abstract

Background: When there is a discontinuity between soft tissue and overlying skin, and the external environment is in direct contact with the bone, such types of fractures are known as open fractures. The frequency of the rate of infection is increased with the increase in size of wounds. Several factors determine the choice of antibiotics. Those factors include the site of injury, bacterial culture and the sensitivity pattern, severity of the injury and mechanism of the injury.

Objective: This research aims to evaluate the frequency of microorganisms in severe open fractures and determine the pattern of sensitivity to commonly used antibiotics.

Study design: A cross-sectional study

Place and Duration: This study was conducted at Jinnah Postgraduate Medical Center Karachi from November 2021 to November 2022.

Methodology: All the participants of this research were having open fractures. According to the ATLS criteria, every patient was stabilized and resuscitated. Every participant's demographic data such as gender, age, the reason for injury, and duration of injury was recorded. Blood investigations and relevant radiographs were ordered. Levine method was used to take 3 samples of pre-debridement wound swabs. The Kirby-Bauer method was used to test antibiotic sensitivity.

Results: Overall, 180 participants enrolled in this research. These participants were aged from 18 years to 60 years. The mean age was 38.87±7.99 years. The majority of the participants were from the age group of 31-60 years. The mean duration of injury was 8.88 hours. The most common fractured bone was the tibia (n=37) followed by the humerus (n=35). Total positive cultures were noted in 172 patients while no growth in 8 patients.

Conclusion: The majority of open fractures in the extremities showed a positive bacterial culture, with gram-positive pathogens being isolated the most commonly. First-generation Cephalosporin showed the highest sensitivity against gram-positive bacteria among the various medication classes evaluated.