Patterns of Microbial Sensitivity in Patient with Open Fracture with Sign of Infection Admitted to Trauma Center in Central Ethiopia from September 1/2019 to August 31/2021GC

Abstract

Abstract Introduction: An open fracture, also called a compound fracture, is a fracture in which there is an open wound or break in the skin near the site of the broken bone. Fractures that are exposed to environmental contamination through disruption of the soft tissue envelope have been shown to have increased risks of infection, delayed union, nonunion, and even limb amputation. For this reason, early treatment for an open fracture focuses on preventing infection at the site of the injury. Objectives: To assess pattern of microbial sensitivity in patient with open fracture admitted to AaBET hospital. Methods: Descriptive cross sectional study was conducted by retrospective medical record review of the patients with open fracture as well as chart documents of the patients with open fracture admitted in AaBET hospital for the last two years (From September 1/2019 to August 2021). All data of patients with open fracture was retrieved and patients who had culture and sensitivity test were assessed for microbial sensitivity pattern. The necessary clinical data were collected mainly from ward logbook and from the charts of the patients with open fracture. Data entry and analysis was done using SPSS. Descriptive method of data analysis like mean, median and frequency distribution was utilized to discuss the results. Result: A total of thirty-eight open fracture patients who have culture and sensitivity were enrolled in the present study between September 1/2019 to August 31/2021GC. RTA was the major cause of open fractures. Most of the fractures (34.2%) occurred in tibia. Majority of the fractures (63.2%) were grade I&II according to modified G-A classification of open fractures. Poly-microbial was the dominant isolate (39.5%) followed by S.aures(28.9). Ceftriaxon, metronidazole and gentamycine were the commonly prescribed drug and ceftriaxone in combination with metronidazole was frequently used(36.8%). Of the total 38 cases, only 18.4% of the patient were sensitive for three or more commonly used antibiotics and 100% of the case were resistant for three or more commonly used antibiotics. Conclusion and recommendation: Efforts must be done to decrease occurrence of infection in a patient with open fracture and implementation of the institutional protocol for antibiotics for open fracture that will constantly updated based on trend of bacterial isolate profile and their suscebtibility patterns. The government to put in place policies aimed at curtailing injudicious acquisition and use of antibiotics in the country. Larger prospective studies will have paramount importance to formulate national guideline for antibiotics use in open fracture. Keywords: Open fracture, microbial isolate, antibiotics susceptibility