The Trend of Wound Microbial Characteristics in Open Fractures at the University College Hospital, Ibadan

Abstract

Background: Infection remains a significant challenge in the management of open fractures, and microbial characteristic of open fractures will  guide the use of antibiotics as an adjunct in their treatment. The aim was to ascertain the trend in microbial attributes in open fractures and sensitivity pattern especially with the advent of new antibiotics introduced into the hospital drug formulary.

Materials and Methods: This study is a hospital-based prospective study of patients with open fractures presenting between January 2013 and December 2013 in the Accident and Emergency Department, of a tertiary hospital in Nigeria. Swabs of superficial and deep parts of the wound were taken aseptically at the presentation of the patient before wound debridement and commencement of antibiotics. Two other samples and biopsies were taken at the deeper parts of the wound on the 3rd and 7th day of admission. All samples were sent for microscopy, culture and sensitivity  pattern to antibiotics. The result of culture and sensitivity pattern were determined and presented.

Result: One hundred and thirty patients were recruited for the study, the sterile swab was taken from their wounds at presentation, but only 81 patients completed the study (i.e. had swabs taken for 3rd and 7th day). Men constituted 71.5% of the patients with a modal age of 35 years, and a mean age been 36.5 (± 15.8) years. Staphylococcus aureus and Clostridium perfringens were the most predominant aerobic, anaerobic organism cultured. The isolates were sensitive to ciprofloxacin, ceftriaxone, co-amoxiclav, gentamycin, cefotaxime and metronidazole.
Conclusion: The microbial characteristics of the open fracture and antibiotic sensitivity pattern in the emergency department of Hospital were not different from the trend from a previous study in the same centre. The similarity of the superficial and deep culture isolates suggests possible
migration of microbes from the surface to the deeper part of the wounds.

Keywords: Open fracture. Microbial characteristics, Antibiotic Sensitivity Pattern. Ibadan, Nigeria.