Is the Spectrum of Bacterial Infection in Open Long-bone Fractures of the Lower Limb Changing?
| Autor: | Livingston Abel, Christina Marie Joseph, Anand Ashok, Krupakaran Ganesan, Sumant Samuel, Balaji Veeraraghavan |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Current Medical Issues, Vol 22, Iss 3, Pp 151-157 (2024) |
| Druh dokumentu: | article |
| ISSN: | 0973-4651 2666-4054 |
| DOI: | 10.4103/cmi.cmi_2_24 |
| Popis: | Introduction: Recent literature suggests a significant risk of infection by Gram-negative bacilli (GNB) in open Grade III fractures. Our prospective study aimed to identify the rate of infection with multidrug-resistant GNB (MDR-GNB) in open Grade III fractures and also study its clinical outcome. Materials and Methods: A prospective cohort study was conducted from November 2015 to May 2017 on Gustilo and Anderson Grade III open long-bone fractures of the lower limb. Demographic data, injury details, time from injury to receiving antibiotics, and index procedure were noted. Length of hospital stay, number of additional surgeries, and occurrence of complications were also noted. In infected open fractures, bacteriology and resistance pattern of the isolated microorganism were noted. Clinical outcomes of all included study patients were measured at 9 months. Results: A total of 231 patients with 275 open fractures involving femur, tibia, or fibula were studied. There was clinical suspicion of infection in 84 patients (36.4%) with 99 fractures (36%). Culture was positive in 43 patients (51.2%). MDR-GNB infection was seen in 19 patients representing 8.2% of all included study patients. Patients with MDR-GNB infection required a significantly higher percentage of additional surgical procedures than patients with non-MDR-GNB infection (2.2% vs. 0.8%, P < 0.0001) and had a lower return to work status (5.3% vs. 30.7%, P = 0.03), suggesting MDR-GNB infections have a worse outcome. Conclusion: Our study showing a high rate of MDR-GNB infection in open fractures highlights the therapeutic challenges involved in treating this nosocomial problem. MDR-GNB infection in open fractures is a serious cause of morbidity and poor outcome. |
| Databáze: | Directory of Open Access Journals |
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