Current pathogens infecting open fracture tibia and their antibiotic susceptibility at a tertiary care teaching hospital in South East Asia

Islam, MM Shahin Ul; Islam, Shariful; Sultana, Parvin; Manjur, Mushfique; Islam, Muhammad Rafiqul; Halder, Rabin Chandra; Islam, Mohd. Sayedul; Hoque, M.; Faruque, Md. Omar; Haque, A K M Nazmul

doi:10.1016/j.infpip.2022.100205

Cited by 4 publications

(4 citation statements)

References 37 publications

(39 reference statements)

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“…coli and Acinetobacter spp.. These results corresponds to data of trauma wards in other low resource settings, which show similar pathogen distributions in wound infections [ 26 – 28 , 39 ]. Of the five most common pathogens in our sample, three were intrinsically resistant to the most commonly used empiric treatment ceftriaxone ( Acinetobacter spp., P .…”

Section: Discussionsupporting

confidence: 87%

“…However, high quality microbial data on the issue is scarce and no data from Uganda is available. The pathogen prevalence data from open fractures in other tertiary hospitals in low resource settings suggest high rates of wound infection, with predominantly gram-negative bacteria (mainly E. coli, P. aeruginosa, Klebsiella pneumoniae) and a high potential for multi-drug resistance [26][27][28].…”

Section: Wound Infections After Traumatic Injuriesmentioning

confidence: 99%

“…coli , P . aeruginosa , Klebsiella pneumoniae) and a high potential for multi-drug resistance [ 26 – 28 ].…”

Section: Introductionmentioning

confidence: 99%

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A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital

Jung

Kiwanuka

Mbabazi

et al. 2023

PLOS Glob Public Health

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The global spread of antimicrobial resistance (AMR) poses an increasing challenge for clinicians in Uganda, where microbiological diagnostics are not routinely available or accessible. The aim of this study was to determine pathogen prevalence and antibiotic resistance patterns in patients with wound infections following trauma at a national referral hospital in Kampala, Uganda. In addition, the suitability of currently used empirical treatment options in this setting was evaluated. This prospective, observational study analysed antimicrobial prescriptions, culture results and antimicrobial sensitivity testing (AST) of wound swabs and blood samples from patients with clinical signs of wound infections on the trauma ward. A total of 124 patients (n = 99, 79.8% male) with a median age of 30 years (IQR 23–39) were enrolled between October 2021 and January 2022. Wound infections were classified as nosocomial in 69% of the cases. Pathogens were isolated from 122 wound swabs, yielding 238 bacterial isolates. The most prevalent pathogens were gram-negative bacteria including Escherichia coli (n = 48, 20.2%) and Acinetobacter spp. (n = 43, 18.1%). Empiric treatment consisted of ceftriaxone and gentamicin which was administered to 67.2% (n = 78) and 62.1% (n = 72) of patients, respectively. High rates of antimicrobial resistance could be demonstrated across gram-negative and gram-positive species towards the most common empiric antibiotics. Following the AST results, over 95% (n = 111) of patients required a change of treatment. Our findings demonstrate that current empiric treatment for wound infections is missing its target in hospitalized patients in Kampala. To address the growing problem of AMR in Uganda, there is a pressing need to enhance diagnostic capacity and implement structured antimicrobial stewardship programs.

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Section: Discussionsupporting

confidence: 87%

Section: Wound Infections After Traumatic Injuriesmentioning

confidence: 99%

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A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital

Jung

Kiwanuka

Mbabazi

et al. 2023

PLOS Glob Public Health

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“…An anterior cruciate ligament (ACL) is the most frequently injured ligament in the knee joint that is usually injured when engaging in sports activity, but nonsports injuries are not uncommon. [1][2][3] It can occur by landing from a ladder during household activities and even playing with and running after kids. ACL reconstruction aims at establishing a stable knee that will allow the patient to have normal everyday life or to return to sporting activities after surgery.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of arthroscopic primary ACL reconstruction with ipsilateral peroneus longus tendon graft: Experience of 439 cases

et al. 2023

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Anterior cruciate ligament (ACL) tears are frequent ligamentous injuries that necessitate reconstruction in many cases. The patellar tendon and the hamstring tendon are the most frequently utilized autografts for reconstruction. However, both have certain disadvantages. We hypothesized that the peroneus longus tendon would be an acceptable graft for arthroscopic ACL reconstruction. The aim of this study is to determine whether a peroneus Longus tendon transplant is a functionally viable option for arthroscopic ACL reconstruction without compromising donor ankle activity. In this prospective study 439 individuals aged between 18 to 45 years, who underwent ACL reconstruction using ipsilateral Peroneus longus tendon autograft were observed. The injury to the ACL was initially assessed by physical examinations and further confirmed by magnetic resonance imaging (MRI). The outcome was assessed at 6, 12, and 24 months after the surgery using Modified Cincinnati, International Knee Documentation Committee (IKDC), and Tegner-Lysholm scores. The donor ankle stability was evaluated using foot and ankle disability index (FADI) and AOFAS scores, as well as hop tests. Significant (P < .001) improvement in the result of the IKDC score, Modified Cincinnati, and Tegner-Lysholm score was observed at the final follow-up. The Lachman test was mildly (1+) positive only in 7.70% of cases, the anterior drawer became negative in all cases, and the pivot shift test was negative in 97.43% of cases at 24 months after the surgery. FADI and AOFAS scores for donor’s ankle functional assessment were impressive, as were single hop test, triple hop test, and cross over hop test results at 2 years. None of the patients had any neurovascular deficit. However, 6 cases of superficial wound infection were observed, 4 at the port site and 2 at the donor site. All resolved after appropriate oral antibiotic therapy. The peroneus longus tendon can be considered a safe, effective, and promising graft of choice for arthroscopic primary single-bundle ACL reconstruction because it has a good functional outcome and impressive donor ankle function after surgery.

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Infectious profiles in civilian gunshot associated long bone fractures

Ghali,

Venugopal,

Montgomery

et al. 2023

International Orthopaedics (SICOT)

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Current pathogens infecting open fracture tibia and their antibiotic susceptibility at a tertiary care teaching hospital in South East Asia

Cited by 4 publications

References 37 publications

A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital

A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital

A prospective study of arthroscopic primary ACL reconstruction with ipsilateral peroneus longus tendon graft: Experience of 439 cases

Infectious profiles in civilian gunshot associated long bone fractures

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