Introduction. An open fracture refers to a break in the skin, which is exposed to microbial contamination and eventually leads to most complicated infections. X-rays can kill bacteria by causing irreversible DNA damage. Objective. To confirm the role of X-ray exposure in treating infected wound fractures at the lower limb and determine X-ray exposure times. Methods. Fifty-one wound swabs were collected from patients with infected open fractures at the lower limb with grade II, IIIA, B, and C according to the Gustilo and Anderson classification system and then cultured. e bacterial isolates were identified by biochemical tests and the VITEK-2 System and tested against several antibiotics. e X-ray exposure was done for open fractures by radiography (at kV133 and 5 milliambers). Results. e higher isolation rate was recorded for Staphylococcus aureus with 21 (41.2%) isolates, and most of them (20, 95.2%) were isolated from grade II fractures. e isolation rate of Gram-negative bacteria was 25.5% for Escherichia coli with 13 isolates, 19.6% for Pseudomonas aeruginosa with 10 isolates, and 13.7% for Klebsiella pneumoniae with 7 isolates, most of which were isolated from grade III fractures. e isolation rate of P. aeruginosa was 60% (6 isolates) from grade IIIA and 71.4% (5 isolates) from grade IIIB for K. pneumoniae, while for E. coli it was 69.2% (9 isolates) from grade IIIC. All the bacterial isolates recorded high levels of antibiotic resistance against most tested antibiotics. Wound cultures of grade II fractures appeared sterile after the first X-ray exposure, and these wounds were infected with S. aureus or P. aeruginosa. However, cultures of grade IIIA and IIIB fractures appeared sterile after the second X-ray exposure for all isolated bacteria, except for S. aureus (grade IIIA fractures) (after the third X-ray exposure). Grade IIIC fractures showed sterile culture after the third X-ray exposure for wounds infected with P. aeruginosa and E. coli. Conclusions. e study concluded that X-ray exposure showed high effectiveness in treating infected open fractures.

Introduction: Staphylococci emerged as the most frequent nosocomial and community-acquired pathogens. Macrolide-lincosamide-streptogramin (MLS) antibiotics resistance was increasing among Staphylococcus aureus and Staphylococcus epidermidis (S. epidermidis) isolates. Objective: In the present study, the aim was to detect the phenotypic resistance pattern of MLS (constitutive and inducible) among S. aureus and S. epidermidis isolated from Iraqi patients. Methods: A total of 120 staphylococcal isolates (60 S. aureus and 60 S. epidermidis) were isolated from urine, wound swab, blood, and sputum specimens, then specified by the VITEK 2 system. Whole isolates were investigated by the disk-diffusion method against many antibiotics, then they were checked for the MLS phenotype by the D-zone test. Results: Out of 60 S. aureus isolates and 60 S. epidermidis, the isolation rates from wound, urine, blood, and sputum were 66.6 and 50%, 16.7 and 26.7%, 11.7 and 18.3%, and 5% for each species, respectively. The higher frequency rates of resistance were showed against erythromycin, clindamycin, and streptomycin, for both S. aureus with 83.3, 53.3, and 83.3%, respectively, and S. epidermidis with 73.3, 45, and 76.7%, respectively. Constitutive MLS resistance phenotype (MLSc) was shown in 32 isolates (53.3%) of S. aureus and inducible MLS resistance phenotype (MLSi) was noted in 16 isolates (26.7%). Conclusion: The current study concluded that the D-zone test must be applied within the routine work of the antimicrobial susceptibility test for staphylococcal isolates, to exclude the false results of staphylococcal isolates sensitivity against clindamycin.