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Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre

Fracture Related Infection (FRI) represents one of the biggest challenges for Trauma and Orthopaedic surgery. A better understanding of the microbiological profile should assist with decision-making and optimising outcomes. Our primary aim was to report on the microbiological profile of FRI cases tr...

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Autores principales: Patel, Kavi H., Gill, Laura I., Tissingh, Elizabeth K., Galanis, Athanasios, Hadjihannas, Ioannis, Iliadis, Alexis D., Heidari, Nima, Cherian, Benny, Rosmarin, Caryn, Vris, Alexandros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525273/
https://www.ncbi.nlm.nih.gov/pubmed/37760655
http://dx.doi.org/10.3390/antibiotics12091358
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author Patel, Kavi H.
Gill, Laura I.
Tissingh, Elizabeth K.
Galanis, Athanasios
Hadjihannas, Ioannis
Iliadis, Alexis D.
Heidari, Nima
Cherian, Benny
Rosmarin, Caryn
Vris, Alexandros
author_facet Patel, Kavi H.
Gill, Laura I.
Tissingh, Elizabeth K.
Galanis, Athanasios
Hadjihannas, Ioannis
Iliadis, Alexis D.
Heidari, Nima
Cherian, Benny
Rosmarin, Caryn
Vris, Alexandros
author_sort Patel, Kavi H.
collection PubMed
description Fracture Related Infection (FRI) represents one of the biggest challenges for Trauma and Orthopaedic surgery. A better understanding of the microbiological profile should assist with decision-making and optimising outcomes. Our primary aim was to report on the microbiological profile of FRI cases treated over a six-year period at one of Europe’s busiest trauma centres. Secondarily, we sought to correlate our findings with existing anti-microbiological protocols and report on diagnostic techniques employed in our practice. All adult cases of FRI treated in our institution between 2016 and 2021 were identified, retrospectively. We recorded patient demographics, diagnostic strategies, causative organisms and antibiotic susceptibilities. There were 330 infection episodes in 294 patients. A total of 463 potentially pathogenic organisms (78 different species) were identified from cultures, of which 57.2% were gram-positive and 39.7% gram-negative. Polymicrobial cultures were found in 33.6% of cases and no causative organism was found in 17.5%. The most prevalent organisms were Staphylococcus aureus (24.4%), coagulase-negative Staphylococci (14%), Pseudomonas aeruginosa (8.2%), Enterobacter species (7.8%) and Escherichia coli (6.9%). Resistant gram-positive organisms (methicillin resistant Staphylococcus aureus or vancomycin-resistant Enterococci) were implicated in 3.3% of infection episodes and resistant gram-negatives (extended-spectrum beta-lactamase, ampC or carbapenemase-producing bacteria) in 13.6%. The organisms cultured in 96.3% of infection episodes would have been covered by our empirical systemic antibiotic choice of teicoplanin and meropenem. To our knowledge, this is the largest reported single-centre cohort of FRIs from a major trauma centre. Our results demonstrate patterns in microbiological profiles that should serve to inform the decision-making process regarding antibiotic choices for both prophylaxis and treatment.
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spelling pubmed-105252732023-09-28 Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre Patel, Kavi H. Gill, Laura I. Tissingh, Elizabeth K. Galanis, Athanasios Hadjihannas, Ioannis Iliadis, Alexis D. Heidari, Nima Cherian, Benny Rosmarin, Caryn Vris, Alexandros Antibiotics (Basel) Article Fracture Related Infection (FRI) represents one of the biggest challenges for Trauma and Orthopaedic surgery. A better understanding of the microbiological profile should assist with decision-making and optimising outcomes. Our primary aim was to report on the microbiological profile of FRI cases treated over a six-year period at one of Europe’s busiest trauma centres. Secondarily, we sought to correlate our findings with existing anti-microbiological protocols and report on diagnostic techniques employed in our practice. All adult cases of FRI treated in our institution between 2016 and 2021 were identified, retrospectively. We recorded patient demographics, diagnostic strategies, causative organisms and antibiotic susceptibilities. There were 330 infection episodes in 294 patients. A total of 463 potentially pathogenic organisms (78 different species) were identified from cultures, of which 57.2% were gram-positive and 39.7% gram-negative. Polymicrobial cultures were found in 33.6% of cases and no causative organism was found in 17.5%. The most prevalent organisms were Staphylococcus aureus (24.4%), coagulase-negative Staphylococci (14%), Pseudomonas aeruginosa (8.2%), Enterobacter species (7.8%) and Escherichia coli (6.9%). Resistant gram-positive organisms (methicillin resistant Staphylococcus aureus or vancomycin-resistant Enterococci) were implicated in 3.3% of infection episodes and resistant gram-negatives (extended-spectrum beta-lactamase, ampC or carbapenemase-producing bacteria) in 13.6%. The organisms cultured in 96.3% of infection episodes would have been covered by our empirical systemic antibiotic choice of teicoplanin and meropenem. To our knowledge, this is the largest reported single-centre cohort of FRIs from a major trauma centre. Our results demonstrate patterns in microbiological profiles that should serve to inform the decision-making process regarding antibiotic choices for both prophylaxis and treatment. MDPI 2023-08-24 /pmc/articles/PMC10525273/ /pubmed/37760655 http://dx.doi.org/10.3390/antibiotics12091358 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 Article
Patel, Kavi H.
Gill, Laura I.
Tissingh, Elizabeth K.
Galanis, Athanasios
Hadjihannas, Ioannis
Iliadis, Alexis D.
Heidari, Nima
Cherian, Benny
Rosmarin, Caryn
Vris, Alexandros
Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre
title Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre
title_full Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre
title_fullStr Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre
title_full_unstemmed Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre
title_short Microbiological Profile of Fracture Related Infection at a UK Major Trauma Centre
title_sort microbiological profile of fracture related infection at a uk major trauma centre
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525273/
https://www.ncbi.nlm.nih.gov/pubmed/37760655
http://dx.doi.org/10.3390/antibiotics12091358
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