Bacteriological Profiles, Antimicrobial Susceptibility Patterns, and Associated Factors in Patients Undergoing Orthopedic Surgery with Suspicion of Surgical Site Infection at Arba Minch General Hospital in Southern Ethiopia

Abstract

Background In the thoughts of all orthopedicians, the emergence of drug-resistant and biofilm-forming bacterial infections at orthopedic surgical sites is the most feared problem. Thus, this study aimed to determine the bacteriological profiles, antimicrobial susceptibility patterns, and biofilm forming ability of isolates, as well as factors associated with orthopedic surgical site infections (OSSIs). Methods An institution-based cross-sectional study was conducted from March 1st, 2021, to February 30th, 2022 at Arba Minch General Hospital. About 245 suspected orthopedic patients with surgical site infection were enrolled and structured questionnaires were used to collect the required information. Wound swabs or pus aspirates were aseptically collected. The frequency and type of bacterial pathogen(s), antimicrobial susceptibility pattern, and biofilm formation were used to determine and characterize the magnitude of OSSIs. SPSS version 25 was used to analyze factors associated with OSSIs. Results The overall magnitude of symptomatic OSSIs was 29.4% (72/245). External fixation [AOR = 4.761, 95% CI: (1.108–20.457)], implant use [AOR = 3.470, 95% CI: (1.460–8.246)], length of time for surgery [AOR = 3.225, 95% CI: (1.545–6.731)], and post-operative hospitalization [AOR = 4.099, 95% CI: (2.026–8.293)] were all statistically significant. Staphylococcus aureus was the most frequently isolated bacteria, accounting for 76%. Methicillin-resistant was observed in 57.9% and 40% of isolated S. aureus (MRSA) and coagulase-negative staphylococci (CoNS), respectively. One-third of the isolated E. faecium was vancomycin-resistant (VRE). Overall, 67.1% (51/76) of isolates were multidrug-resistant (MDR). About 27.6% (21/76) of isolates were found to be strong biofilm producers. Conclusion OSSIs were shown to be caused by a significant number of drug-resistant and biofilm-producing bacterial isolates. To mitigate the problem, aseptic surgical practice and conventional wound management, as well as constant observation of antimicrobial resistant patterns, should be followed.

The microbiome of orthopedic implant-associated infections and its correlation with inflammatory markers

“…Among the GPC, all the isolates of S. aureus and cogulase negative S. aureus are sensitive to vancomycin with MIC <1. The pattern of susceptibility of E. faecalis is found to be 100% susceptibility for penicillin, ampicillin, linezolid vancomycin, and high-level gentamicin well correlating with studies of Alelign et al, 20 where all 33% of enterococcus isolated showed 100% vancomycin susceptibility. 3 In the present study, the total biofilm production tested by tube method is 54% biofilm producers and 46% non-biofilm producers.…”

Quality Assurance with Reference Quality Control Strains in Antimicrobial Susceptibility Testing: Need for Quality Antimicrobial-Resistant Research [Letter]

“…Alelign et al reported interesting data on “Bacteriological Profiles, Antimicrobial Susceptibility Patterns, and Associated Factors in Patients Undergoing Orthopaedic Surgery with Suspicion of Surgical Site Infection at Arba Minch General Hospital in Southern Ethiopia.” 1 We appreciate the efforts taken to investigate thoroughly the Multidrug-resistant [MDR] bacterial profile in orthopedic surgical site infections (OSSIs). Globally infections caused by MDR organisms are a significant cause of treatment failure and dissemination in hospitals and community settings.…”

Insights into the microbiological and virulence characteristics of bacteria in orthopaedic implant infections: A study from Pakistan

“…Different studies showed that Staphylococcus aureus accounts for 20-30% of infections whereas the coagulase-negative Staphylococci are responsible for approximately 20-40% of surgical implant infections. Other less frequent microbes identified in the orthopaedic implant-associated infections include the Gram-positive cocci, such as Streptococci and Enterococci, as well as Gram-negative bacilli, for example Pseudomonas aeruginosa and the Enterobacteriaceae family [21][22][23][24].…”