Taufik Ahmad, Wiweko Adnanto, Yudhanto Didit, Wardoyo E Hagni, Habib Philip, Rizki Mohammad, Rosyidi Rohadi Muhammad
Orthopaedic and Traumatology Subdivision, Department of Surgery, Medical Faculty of Mataram University, Mataram University Hospital, Mataram, Indonesia.
Doctorate Program, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Ann Med Surg (Lond). 2022 Mar 28;76:103510. doi: 10.1016/j.amsu.2022.103510. eCollection 2022 Apr.
The annual incidence of open fracture in Dr Soetomo Hospital, East Java were 400 cases with chronic infection complications exist in 14% (57 cases). A previous study in this hospital shows the resistance rate of Pseudomonas towards cefazolin and amikacin was 100% and 15%, respectively. The objective of this study was to identify bacterial infection type and antibiotic resistance pattern in infection caused by the open fracture.
This was an analytic cross-sectional study. Samples were collected from three debridement surgery sites in Mataram Hospital, Mataram University Hospital, and Islamic Mataram Hospital from September 2019 until October 2020. Specimens from wound infection were cultured, and an antibiotic sensitivity test was performed.
Approximately 213 samples were analyzed in this study, comprising open fracture grade 3A (45%) and 3B (39%). The majority of fractures were lower extremity fractures (62%). Bacterial infection were found in 35% cases (80 isolates) in which 62,5% (50 isolates) were gram-positive bacteria and 37,5% (30 isolates) were gram-negative bacteria Infection in open fracture was equivalent to grading. The predominant bacterial infection was caused by gram-positive bacteria, including and Staphylococcus negative coagulase. Gram-positive bacteria were sensitive towards Cepoferazone, Sulbactam and Ofloxacin, whereas gram-negative bacteria remains sensitive against Doxicyclin and Amicasin.
Infection in open fracture was equivalent with the grade, and gram-positive were predominantly sensitive with cefoperazone sulbactam.
东爪哇省苏托莫医院开放性骨折的年发病率为400例，其中14%（57例）存在慢性感染并发症。此前该医院的一项研究表明，铜绿假单胞菌对头孢唑林和阿米卡星的耐药率分别为100%和15%。本研究的目的是确定开放性骨折所致感染的细菌感染类型及抗生素耐药模式。
这是一项分析性横断面研究。2019年9月至2020年10月期间，从马塔兰医院、马塔兰大学医院和伊斯兰马塔兰医院的三个清创手术部位采集样本。对伤口感染标本进行培养，并进行抗生素敏感性试验。
本研究共分析了约213份样本，其中3A 级开放性骨折占45%，3B级占39%。大多数骨折为下肢骨折（62%）。35%的病例（80株分离菌）发现细菌感染，其中62.5%（50株）为革兰氏阳性菌，37.5%（30株）为革兰氏阴性菌。开放性骨折感染与分级相当。主要的细菌感染由革兰氏阳性菌引起，包括凝固酶阴性葡萄球菌。革兰氏阳性菌对头孢哌酮、舒巴坦和氧氟沙星敏感，而革兰氏阴性菌对多西环素和阿米卡星仍敏感。
开放性骨折感染与分级相当，革兰氏阳性菌对头孢哌酮舒巴坦主要敏感。
