Retrospective study on the etiological spectrum and antibiotic resistance in infections associated with osteosynthesis materials.

AIM: To determine the prevalence of infections according to their etiologic spectrum and antibiotic sensitivity in patients with or without implants and endoprostheses.

MATERIAL AND

METHODS

This retrospective study was conducted based on a customized study protocol on 773 cases admitted to the Clinic of Orthopedics - Traumatology of the Iaşi "Sf. Spiridon" Emergency Hospital in the interval January 1, 2003 - December 31, 2011 for postoperative infectious complication.

RESULTS

S. aureus was more frequently found in the patients without implant (58.2%) and in those with subcutaneous implant (45.5%); the lowest frequency was noticed in the patients with endoprosthesis (27.1%), the frequency distributions showing marked statistically significant differences (p = 0.001). P. aeruginosa was more frequently detected in the patient group with endoprosthesis (30.2%), while in the other groups it was found in approximately 7% (p = 0.001). The presence of Acinetobacter spp. was significantly higher in patients with deep implant (12.9%), with the lowest frequency noticed in the patients without implant (4.5%) (p = 0.029). Of the total isolated and identified types, 59.6% were non-multidrug-resistant (non-MDR), the remaining 40.4% being MDR types.

CONCLUSIONS

S. aureus was the most frequent etiological agent in patients with or without cutaneous implant (45.5 and 58.2%, respectively), and P. aeruginosa (30.2%) in the endoprosthesized patients. Implementation of a preoperative screening protocol for the identification of healthy S. aureus carriers (Methicillin-sensitive S. aureus - MSSA/Methicillin-resistant S. aureus - MRSA) and subsequent decolonization would be an efficient way of reducing the incidence of infections caused by this bacterium.