Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures

Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures

Introduction: This study was conducted to evaluate the susceptibility of microorganisms involved in early infection of open fractures in orthopaedics to current prophylactic antibiotics practice and determine the association of various parameters related to the causative organism, patient, injury...

Full description

Bibliographic Details
Main Authors: Meng, Tai Ken, Sulong, Ahmad Fadzli, Mohd Yusof, Nazri
Format: Article
Language:English
Published: Kuliyyah of Medicine, IIUM 2019
Subjects:
RD701 Orthopedics
Online Access:http://irep.iium.edu.my/77239/
http://irep.iium.edu.my/77239/
http://irep.iium.edu.my/77239/1/microbial%20drug%20resistance%20profile%20imjm.pdf
id iium-77239
recordtype eprints
spelling iium-772392020-01-09T17:50:59Z http://irep.iium.edu.my/77239/ Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures Meng, Tai Ken Sulong, Ahmad Fadzli Mohd Yusof, Nazri RD701 Orthopedics Introduction: This study was conducted to evaluate the susceptibility of microorganisms involved in early infection of open fractures in orthopaedics to current prophylactic antibiotics practice and determine the association of various parameters related to the causative organism, patient, injury and management to the resistance of such microorganisms. Methods: This is a retrospective study that reviewed cases collected from the surgical operations record from January 2015 to December 2017 in Hospital Tengku Ampuan Afzan, Kuantan. A total of 179 cases were collected with 110 cases fulfilling the proposed inclusion / exclusion criteria. They all underwent routine debridement followed by culture and sensitivity. Previous clinical records were traced to identify the various risk factors for infection and evaluate these against the resistance of the microorganisms to prophylactic antimicrobial drugs. Results: Admission to the intensive care unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of admission were all significantly associated with resistance of microorganism. The study also demonstrated the predominance of Gram-negative microorganisms constituting 65.9% of isolates. Gramnegative microorganisms were seen more in higher fracture grades and Injury Severity Scale, and longer duration of admission and antibiotic treatment. The overall susceptibility of microorganisms to antibiotics was also demonstrated with up to 68.6% resistance to cefuroxime and 36.9% to Gentamicin. Staphylococcus aureus and MRSA were the commonest Gram-positive organisms while Pseudomonas and Acinetobacter spp. the commonest Gram-negatives. Conclusion: Admission to Intensive Care Unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of antibiotics have a significant positive predictive value to the development of resistance of microorganisms. The shift to predominantly Gram-negative microorganisms indicate an urgency to modify management of open fracture to achieve optimal results. This will also prevent the emergence of new multi-drug resistance microorganism which is already a worldwide public health problem. Kuliyyah of Medicine, IIUM 2019-12-17 Article PeerReviewed application/pdf en http://irep.iium.edu.my/77239/1/microbial%20drug%20resistance%20profile%20imjm.pdf Meng, Tai Ken and Sulong, Ahmad Fadzli and Mohd Yusof, Nazri (2019) Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures. IIUM Medical Journal Malaysia, 18 (3). pp. 96-103. ISSN 18234631 https://journals.iium.edu.my/kom/index.php/imjm/issue/view/2
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic RD701 Orthopedics
spellingShingle RD701 Orthopedics
Meng, Tai Ken
Sulong, Ahmad Fadzli
Mohd Yusof, Nazri
Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
description Introduction: This study was conducted to evaluate the susceptibility of microorganisms involved in early infection of open fractures in orthopaedics to current prophylactic antibiotics practice and determine the association of various parameters related to the causative organism, patient, injury and management to the resistance of such microorganisms. Methods: This is a retrospective study that reviewed cases collected from the surgical operations record from January 2015 to December 2017 in Hospital Tengku Ampuan Afzan, Kuantan. A total of 179 cases were collected with 110 cases fulfilling the proposed inclusion / exclusion criteria. They all underwent routine debridement followed by culture and sensitivity. Previous clinical records were traced to identify the various risk factors for infection and evaluate these against the resistance of the microorganisms to prophylactic antimicrobial drugs. Results: Admission to the intensive care unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of admission were all significantly associated with resistance of microorganism. The study also demonstrated the predominance of Gram-negative microorganisms constituting 65.9% of isolates. Gramnegative microorganisms were seen more in higher fracture grades and Injury Severity Scale, and longer duration of admission and antibiotic treatment. The overall susceptibility of microorganisms to antibiotics was also demonstrated with up to 68.6% resistance to cefuroxime and 36.9% to Gentamicin. Staphylococcus aureus and MRSA were the commonest Gram-positive organisms while Pseudomonas and Acinetobacter spp. the commonest Gram-negatives. Conclusion: Admission to Intensive Care Unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of antibiotics have a significant positive predictive value to the development of resistance of microorganisms. The shift to predominantly Gram-negative microorganisms indicate an urgency to modify management of open fracture to achieve optimal results. This will also prevent the emergence of new multi-drug resistance microorganism which is already a worldwide public health problem.
format Article
author Meng, Tai Ken
Sulong, Ahmad Fadzli
Mohd Yusof, Nazri
author_facet Meng, Tai Ken
Sulong, Ahmad Fadzli
Mohd Yusof, Nazri
author_sort Meng, Tai Ken
title Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
title_short Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
title_full Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
title_fullStr Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
title_full_unstemmed Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
title_sort retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures
publisher Kuliyyah of Medicine, IIUM
publishDate 2019
url http://irep.iium.edu.my/77239/
http://irep.iium.edu.my/77239/
http://irep.iium.edu.my/77239/1/microbial%20drug%20resistance%20profile%20imjm.pdf
first_indexed 2023-09-18T21:48:57Z
last_indexed 2023-09-18T21:48:57Z
_version_ 1777413639146307584

Similar Items