Unblinded randomized control trial on prophylactic antibiotic use in gustilo II open tibia fractures at Kenyatta National Hospital, Kenya

Ondari, Joshua N; Masika, Moses; Ombachi, R; Ating’a, J

doi:10.1016/j.injury.2016.07.014

Cited by 18 publications

(27 citation statements)

References 20 publications

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“…Local studies on open tibia fractures have demonstrated similar distributions(14)(15)(16). These studies also had comparable distribution of fractures as per the Gustillo 0% 20% 40% 60% 80%100%120%…”

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confidence: 69%

Early Bacterial Cultures from Open Fractures - Differences Before and After Debridement

Sitati¹,

Mosi²,

Mwangi³

2018

Ann Afr Surg.

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Background: The pattern of organisms found in open fractures is important in the selection of antibiotics for prophylaxis and empirical treatment. So far, there is paucity of data on local patterns of bacteria contaminating and infecting open fractures and their antibiotic susceptibility profile. Objective: To describe the pattern and antibiotic susceptibility of bacterial isolates obtained within 24 hours of injury from open fractures and to compare these to bacterial isolates from fractures that subsequently develop infection. Methods:A prospective study of 98 patients with open fractures seen at Kenyatta National Hospital (KNH) within 24 hours of injury between November 2015 and March 2016 was conducted. Swabs for culture and sensitivity were taken from the wounds and antibiotics initiated.Surgical debridement was subsequently carried out witha 14 day follow up for wound infection. Wounds thatbecame infected were sampled for cultures And sensitivity. Results: Fifty-one (52.2%) pre debridement wound samples had positive cultures. Staphylococcus aureus and (Coagulase Negative) CON Staphylococci were the predominant gram positive isolates. At 14 days' follow-up, the infection rate was58.9 %. The predominant gram positive isolate was Staphylococcus aureus. Only 5.7% of the predebridement isolates were similar to the post debridement isolates. Conclusions: The contaminating organisms are not similar to the organisms isolated from injuries that later develop infection.

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confidence: 69%

Early Bacterial Cultures from Open Fractures - Differences Before and After Debridement

Sitati¹,

Mosi²,

Mwangi³

2018

Ann Afr Surg.

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“…Earlier studies done at Kenyatta National Hospital have revealed higher rates than those observed globally. Asif (2011) reported an SSI rate of 50% in all open fractures, while Ondari et al (2016) found a 28% infection rate in Gustilo II open fractures.…”

Section: Introductionmentioning

confidence: 99%

“…Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License prophylactic amputations to avoid the sequelae of infection, sepsis, and death (Pappe and Webb, 2008). Most studies report infection rates between 10 -50% (Asif, 2011;Ioannis et al, 2014;Marcelo et al, 2017;Ondari et al, 2016). Earlier studies done at Kenyatta National Hospital have revealed higher rates than those observed globally.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of bacterial isolates profile in infected open fractures

Thuita¹,

Chumo²,

Muthike³

2021

Afr. J. Microbiol. Res.

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The most common complication in open fractures is infection, which often escalates to sepsis, osteomyelitis, and amputations. The use of prophylactic antibiotics is one of the most effective strategies to prevent infection. The prevailing bacterial isolate patterns must guide the choice of antibiotics for both prophylactic and empiric therapy. This study aims to describe the bacterial isolate profiles in infected open fractures. A prospective cross-sectional study was carried out at Kenyatta National Hospital, Kenya, between October 2019 and January 2020. 66 infected open fractures were identified and pus swabs/infected tissue specimens taken for bacterial cultures. Other data were collected from patient interviews and their hospital records. Results revealed that the culture growth rate was 79%. Gram-negative isolates accounted for 73% while Gram-positive isolates were 27%. The most pre-dominant bacterial isolate was Pseudomonas aeruginosa (34%), followed by Staphylococcus aureus (27%), Escherichia coli (20%), Proteus mirabilis (16%) and Klebsiella pneumoniae (3%). There were more gram-negative than gram-positive bacterial isolates. The pre-dominant bacterial isolate was P. aeruginosa followed by S. aureus. The higher proportion of gram negative isolates is in variance with what is widely documented in the literature. The selection of antibiotics for both prophylaxis and empiric therapy should be tailored to the local patterns of bacterial isolates.

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“…2 Jaw fractures may affect oral implant treatments and delay the healing of jaw injury. 3 Additionally, they can lead to the loss of jaw bone mass, accelerate alveolar bone atrophy, and reduce the height of alveolar bone, thereby affecting the outcome of prosthodontic therapy. 3 Micro (mi)RNAs are a class of short, single-stranded non-coding RNAs that are extensively distributed in animals and plants.…”

Section: Introductionmentioning

confidence: 99%

“…3 Additionally, they can lead to the loss of jaw bone mass, accelerate alveolar bone atrophy, and reduce the height of alveolar bone, thereby affecting the outcome of prosthodontic therapy. 3 Micro (mi)RNAs are a class of short, single-stranded non-coding RNAs that are extensively distributed in animals and plants. 4 They function in posttranscriptional regulation by binding specifically with the 3 0 untranslated region of target mRNAs, thereby regulating the expression of multiple genes involved in several biological processes including cell growth, differentiation, apoptosis, and tumorigenesis.…”

Section: Introductionmentioning

confidence: 99%

The function of microRNA-211 expression in post-fracture bone cell apoptosis involving the transforming growth factor-β/ phosphoinositide 3-kinase signaling pathway

Sun

Yang

et al. 2020

J Int Med Res

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Background The underlying mechanism of micro (mi)RNA-211 in bone cell apoptosis after fracture remains unclear. This study aimed to determine the effect and function of miRNA-211 in bone cell apoptosis in fracture patients. Methods Serum samples were collected from patients with fractures and healthy controls. Serum miR-211 expression was detected by quantitative PCR. MC3T3-E1 cells were transfected with a transforming growth factor (TGF)-β inhibitor and phosphoinositide 3-kinase (PI3K) inhibitor. The viability of MC3T3-E1 cells was detected by the MTT assay, and apoptosis was detected by flow cytometry. Caspase-3/9 activity and the protein expression of TGF-β, PI3K, and p-Akt were detected by western blot and immunoprecipitation. Results In the fracture group, miRNA-211 expression was significantly up-regulated compared with controls. We used miRNA-211 mimics to up-regulate miRNA-211 expression, and observed inhibited cell viability and induced apoptosis and lactate dehydrogenase (LDH) activity. miRNA-211 up-regulation also suppressed the expression of TGF-β, PI3K, and p-Akt proteins. Conversely, miRNA-211 down-regulation increased cell viability and reduced apoptosis and LDH activity, as well as inducing the expression of TGF-β, PI3K, and p-Akt. Inhibiting TGF-β decreased the effect of anti-miRNA-211 on osteocyte apoptosis. Conclusion Our data indicate that miRNA-211 functions via the TGF-β/PI3K/Akt signaling pathway in patients with fractures.

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Unblinded randomized control trial on prophylactic antibiotic use in gustilo II open tibia fractures at Kenyatta National Hospital, Kenya

Cited by 18 publications

References 20 publications

Early Bacterial Cultures from Open Fractures - Differences Before and After Debridement

Early Bacterial Cultures from Open Fractures - Differences Before and After Debridement

A prospective study of bacterial isolates profile in infected open fractures

The function of microRNA-211 expression in post-fracture bone cell apoptosis involving the transforming growth factor-β/ phosphoinositide 3-kinase signaling pathway

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