Incidence of Post-Operative Wound Infections and Bacterial Antibiotic Sensitivity Patterns in Compound Fractures.

Objectives: To know the incidence of post-operative wound infections in compound fractures & to evaluate the bacterial isolate and to identify the antibiotic sensitivity patterns in compound fractures to facilitate the use of effective prophylactic antibiotics to prevent infections. Methodology: This was a prospective study conducted at Jawahar Lal Nehru Medical College and Hospital between 1st may 2014 to 31st July 2014.This study included all the patients with Compound fractures of extremities, presenting to Orthopaedic emergency. All the open fractures were classified according to the Gustilo and Anderson’s classification. Two pus culture swabs were taken in all patients under all aseptic precautions. First sample was taken at time of arrival of patient at emergency department, and immediately sent for culture and sensitivity. Prophylactic antibiotic (i.v. cefoperazone) was started immediately after taking the first culture. Second pus culture swab was taken after three days, at the time of wound inspection. All the fractures were managed with thorough wound debridement and fracture stabilization. Data was collected according to set proforma, regarding the results of initial and post-operative swab cultures and were analysed. Observation & Results: This study involved fourty patients with compound fractures of extremities presenting to the emergency department. The incidence of wound infection before any operative procedure i.e, first pus culture in the study was fifty five percentage.. Out of twenty two infected cases thirteen patients had staphylococcus aureus as the growing organism. All Staph.aureus were found to be sensitive to amikacin, vancomycin. The incidence of wound infection in second pus culture report was found to be thirty percentages. In the second swab culture sample which was taken on third day, eight (twenty percentage) cultures showed Staph. aureus. Six were sensitive to amikacin, six were sensitive to cefazoline. Conclusion: Compound fractures are associated with high incidence of infection. Antibiotics should be such that it covers all the commonly infecting organisms. In this study the commonest infecting organism was found to be Staph. aureus followed by E. fecalis, Citrobacter, E. coli and Klebsiella. It indicates that antibotics should be given initially empirically to cover the Gram positive and negative bacteria followed by giving specific antibiotics following pus culture report to combat and eradicate wound infection. Most of these organisms were found to be sensitive to Cephalosporins, Vancomycin and Aminoglycosides. Thus it is highly recommended that Prophylactic antibiotics in the management of compound fractures should always include one Cephalosporin or Vancomycin and one Aminoglycoside to cover the commonly infecting organisms. The results of this study may hold true for elective Orthopaedic procedures also.

Infecções hospitalares e resistência microbiana em Unidade de Cuidados Intensivos de um Hospital Universitário / Nosocomial infections and resistance microbian in Intensive Care Unit of a University Hospital: an epidemiological study

In the last decades it has been observed an increase in frequency on nosocomial infections by resistant microorganisms, especially in Intensive Care Units (ICU). This study aimed to determine main sites of nosocomial infections and prevalence of multidrug resistant microorganisms. An epidemiological and descriptive study was developed in an adult ICU of a University Hospital of Belo Horizonte, Minas Gerais, from January to December, 2004. Among the most prevalent nosocomial infections were pneumonia, urinary tract infections, and bloodstream infections. Among the resistant microorganisms prevailed Pseudomonas aeruginosa, Acinetobacter baumanii, MRSA, Klebsiella, Enterobacteriaceas and Serratia. As this study is still going on, we expect to determine temporal trends for resistant microorganisms related to nosocomial infections main sites.

Nas últimas décadas tem-se observado o aumento da freqüência das infecções hospitalares (IH) por microrganismos resistentes. Essa realidade é ainda mais evidente em Unidades de Tratamento Intensivo (UTI). Objetivou-se nesse estudo determinar os principais sítios de ocorrência das IH e a prevalência dos microrganismos multirresistentes, nesta unidade. Tratou-se de um estudo epidemiológico, descritivo, desenvolvido na UTI adulto de um Hospital Universitário de Belo Horizonte, Minas Gerais no período de janeiro a dezembro de 2004. Dentre as infecções hospitalares mais prevalentes apresentadas verificou-se que a pneumonia, infecção do trato urinário e da corrente sangüínea foram respectivamente as mais importantes. Na prevalência do microrganismo resistente destacaram a Pseudomonas aeruginosa, Acinetobacter baumanii, MRSA, Klebsiella, Enterobacteriáceas e Serratia. Sendo este um projeto em continuidade espera-se determinar em um período maior a tendência temporal dos microrganismos resistentes correlacionados aos principais sítios de IH.

The Effect of Antibiotic and Steroid Drops Following Strabismus Surgery

Many opthalmologists prefer to treat the eyes operated on with drops containing corticosteroids and antibiotics for a few days of a few weeks after strabismus surgery. But no controlled studies are available to support the rationale for such therapy. Therefore, we conducted a prespective double-blind masked trial to evaluate the clinical effectiveness of the drops containing antibiotics and steroid on 40 patients. There are no singnificant difference between the drug and the placebo groups.

The Effect of Antibiotic and Steroid Drops Following Strabismus Surgery

Many opthalmologists prefer to treat the eyes operated on with drops containing corticosteroids and antibiotics for a few days of a few weeks after strabismus surgery. But no controlled studies are available to support the rationale for such therapy. Therefore, we conducted a prespective double-blind masked trial to evaluate the clinical effectiveness of the drops containing antibiotics and steroid on 40 patients. There are no singnificant difference between the drug and the placebo groups.