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Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China

Bacterial contamination of soft tissue in open fractures leads to high infection rates. Pathogens and their resistance against therapeutic agents change with time and vary in different regions. The purpose of this study was to characterize the bacterial spectrum present in open fractures and analyze...

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Autores principales: Zhong, Wanrun, Wang, Yanmao, Wang, Hongshu, Han, Pei, Sun, Yi, Chai, Yimin, Lu, Shengdi, Hu, Chengfang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219466/
https://www.ncbi.nlm.nih.gov/pubmed/37240904
http://dx.doi.org/10.3390/jpm13050735
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author Zhong, Wanrun
Wang, Yanmao
Wang, Hongshu
Han, Pei
Sun, Yi
Chai, Yimin
Lu, Shengdi
Hu, Chengfang
author_facet Zhong, Wanrun
Wang, Yanmao
Wang, Hongshu
Han, Pei
Sun, Yi
Chai, Yimin
Lu, Shengdi
Hu, Chengfang
author_sort Zhong, Wanrun
collection PubMed
description Bacterial contamination of soft tissue in open fractures leads to high infection rates. Pathogens and their resistance against therapeutic agents change with time and vary in different regions. The purpose of this study was to characterize the bacterial spectrum present in open fractures and analyze the bacterial resistance to antibiotic agents based on five trauma centers in East China. A retrospective multicenter cohort study was conducted in six major trauma centers in East China from January 2015 to December 2017. Patients who sustained open fractures of the lower extremities were included. The data collected included the mechanism of injury, the Gustilo-Anderson classification, the isolated pathogens and their resistance against therapeutic agents, as well as the prophylactic antibiotics administered. In total, 1348 patients were included in our study, all of whom received antibiotic prophylaxis (cefotiam or cefuroxime) during the first debridement at the emergency room. Wound cultures were taken in 1187 patients (85.8%); the results showed that the positive rate of open fracture was 54.8% (651/1187), and 59% of the bacterial detections occurred in grade III fractures. Most pathogens (72.7%) were sensitive to prophylactic antibiotics, according to the EAST guideline. Quinolones and cotrimoxazole showed the lowest rates of resistance. The updated EAST guidelines for antibiotic prophylaxis in open fracture (2011) have been proven to be adequate for a large portion of patients, and we would like to suggest additional Gram-negative coverage for patients with grade II open fractures based on the results obtained in this setting in East China.
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spelling pubmed-102194662023-05-27 Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China Zhong, Wanrun Wang, Yanmao Wang, Hongshu Han, Pei Sun, Yi Chai, Yimin Lu, Shengdi Hu, Chengfang J Pers Med Communication Bacterial contamination of soft tissue in open fractures leads to high infection rates. Pathogens and their resistance against therapeutic agents change with time and vary in different regions. The purpose of this study was to characterize the bacterial spectrum present in open fractures and analyze the bacterial resistance to antibiotic agents based on five trauma centers in East China. A retrospective multicenter cohort study was conducted in six major trauma centers in East China from January 2015 to December 2017. Patients who sustained open fractures of the lower extremities were included. The data collected included the mechanism of injury, the Gustilo-Anderson classification, the isolated pathogens and their resistance against therapeutic agents, as well as the prophylactic antibiotics administered. In total, 1348 patients were included in our study, all of whom received antibiotic prophylaxis (cefotiam or cefuroxime) during the first debridement at the emergency room. Wound cultures were taken in 1187 patients (85.8%); the results showed that the positive rate of open fracture was 54.8% (651/1187), and 59% of the bacterial detections occurred in grade III fractures. Most pathogens (72.7%) were sensitive to prophylactic antibiotics, according to the EAST guideline. Quinolones and cotrimoxazole showed the lowest rates of resistance. The updated EAST guidelines for antibiotic prophylaxis in open fracture (2011) have been proven to be adequate for a large portion of patients, and we would like to suggest additional Gram-negative coverage for patients with grade II open fractures based on the results obtained in this setting in East China. MDPI 2023-04-26 /pmc/articles/PMC10219466/ /pubmed/37240904 http://dx.doi.org/10.3390/jpm13050735 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Zhong, Wanrun
Wang, Yanmao
Wang, Hongshu
Han, Pei
Sun, Yi
Chai, Yimin
Lu, Shengdi
Hu, Chengfang
Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China
title Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China
title_full Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China
title_fullStr Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China
title_full_unstemmed Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China
title_short Bacterial Contamination of Open Fractures: Pathogens and Antibiotic Resistance Patterns in East China
title_sort bacterial contamination of open fractures: pathogens and antibiotic resistance patterns in east china
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219466/
https://www.ncbi.nlm.nih.gov/pubmed/37240904
http://dx.doi.org/10.3390/jpm13050735
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