A STUDY ON BACTERIAL ISOLATES AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERN IN PATIENTS WITH COMPOUND FRACTURE WOUNDS IN A TERTIARY CARE HOSPITAL

Introduction Compound fractures (open fractures) are those exposed to the outside environment through a skin wound. In India, Road Traffic Accidents forms the single largest contributor of open fractures with approximately 85,000 people being killed every year and more than 1.2 million having serious limb injuries. Aim To detect the bacterial profile and evaluate their antimicrobial sensitivity pattern in open fracture wound infections and determine their resistance pattern (Methicillin resistance and Extended spectrum beta lactamase ESBL resistance pattern). Materials and Methods This study was done in patients with open fracture wound infections. Pus samples were collected from open fracture wounds using sterile swab and processed by Gram staining and aerobic bacterial methods. Antibiotic susceptibility testing was done by disc diffusion method (Kirby Bauer method) on Mueller Hinton agar. Results Out of 200 samples, 161 samples were culture positive. 134 (67 percent) isolates were monomicrobial , 27 (13.5 percent) isolates were of polymicrobial growth and 39 (19.5 percent) isolates showed no growth. Totally, 188 isolates were obtained from 161 culture positive cases. Staphylococcus aureus (26.06 percent) was the predominant pathogen from open fracture wound infection followed by Staphylococcus epidermidis (21.8 percent) and Proteus mirabilis (14.39 percent). Out of 49 S. aureus and 41 S.epidermidis isolates 22 (44.8 percent) and 19 (46.34 percent) were detected as Methicillin resistant respectively.Out of 98 GNB isolated, 62 (63.3percent) showed ESBL resistant pattern. The GPC isolated were 100 percent sensitive to Vancomycin and 83.05 percent sensitive to Amikacin. The GNB isolates were sensitive to Imipenem (100 percent), Cefoperazone-sulbactum (83.33percent ), Ciprofloxacin (77.33 percent)and Gentamicin (71 percent). Conclusion This study revealed Staphylococcus aureus as the predominant bacterial pathogen from open fracture wound An Initiative of The Tamil Nadu Dr. M.G.R. Medical University University Journal of Pre and Para Clinical Sciences infections. A high degree of Methicillin resistance and ESBL resistant patterns noted in this isolates plays a crucial role in the management of these patients.