RETROSPECTIVE STUDY ON THE ETIOLOGICAL SPECTRUM AND ANTIBIOTIC RESISTANCE IN INFECTIONS ASSOCIATED WITH OSTEOSYNTHESIS MATERIALS

Abstract

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.