Superficial swab cultures in open fracture management: insights from a resource-poor setting
| Autor: | O D Ojo, F.V. Daniel, A.K. Ako-Nai, I.C. Ikem, Kehinde Sunday Oluwadiya, Lawrence M. Oginni |
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| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Open fracture Time Factors Nursing (miscellaneous) Microbiological culture Nigeria Therapeutic irrigation Microbial Sensitivity Tests medicine.disease_cause Hospitals University Fractures Open Predictive Value of Tests Risk Factors Humans Medicine Prospective Studies Therapeutic Irrigation Prospective cohort study Developing Countries Resource poor Bacteriological Techniques business.industry Bacterial Infections Combined Modality Therapy Wound infection Anti-Bacterial Agents Surgery Early Diagnosis Debridement Staphylococcus aureus Predictive value of tests Wound Infection Fundamentals and skills business |
| Zdroj: | Journal of Wound Care. 19:432-438 |
| ISSN: | 2052-2916 0969-0700 |
| DOI: | 10.12968/jowc.2010.19.10.79090 |
| Popis: | Objective To identify bacterial isolates from superficial swabs of open fracture wounds at presentation and after infection has been established, and to determine if there are correlations between them. Method Patients who presented with open fractures at the Wesley Guild Hospital, Ilesa, Nigeria between December 2004 and May 2006 were recruited into this prospective study. Superficial wound swabs were taken at presentation and if patient showed evidence of wound infection. Results Sixty patients had open fractures. The initial bacteria culture of wound swabs taken on the day of presentation was positive in 41 (68.3%) patients. Of these, 19 (46.3%) yielded one bacteria isolate, 17 (41.5%) yielded two and 5 (12.2%) yielded three, making a total of 68 organisms. The most common organism was Staphylococcus aureus. However, as a group, more aerobic Gram-negative rods were isolated than any other bacteria groups. Eleven (18.3%) patients developed wound infections, all of which were polymicrobial. In 10 (90.9%) of these, the microbial isolate of the final wound swab included at least one organism that was present in the initial wound culture. No patient with an initial negative culture went on to develop a wound infection. The mean presentation interval of patients with wounds that became infected was 15.2 ± 7.9 hours (95% CI 9.8–20.5 hours) compared with 2.9 ± 3.1 hours (95% CI 2.0–3.8 hours) for those who did not develop a wound infection (p>0.01). Conclusion In a resource-poor setting, where pre-hospital care is unavailable and patients present late, superficial wound swabs are effective in predicting subsequent organisms that may cause wound infections. Conflict of interest None. |
| Databáze: | OpenAIRE |
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