RESUMO
Objective: to determine the frequency and antibiotic sensitivity of methicillin resistant staphylococcus aureus [MRSA] in open fractures
Study design: descriptive case series
Place and Duration of study: Orthopaedics and Traumatology Unit A Lady Reading Hospital Peshawar, from January 2014 to June 2016
Methodology: patients of both gender and all ages fulfilling the inclusion criteria were included in this study. Swabs were taken from wounds with Levine's technique and sent to the hospital laboratory immediately where standard methodology was adopted for culture and sensitivity of the pathogens in all cases and results were reported as per Clinical and Laboratory Standards Institute [CLSI] guidelines. All MRSA positive cases were isolated within 24 hours and the standard MRSA protocol implemented immediately
Result: a total of 200 open fractures were sampled over a period of two and a half years. Positive cultures of MRSA were obtained in 47[23.5%] patients. The mean age of the patient was 24 year [range 18 year to 52 year]. Males were 43[81.4%] while females 4[8.5%] in number. Open tibial fractures were highest [n=21, 44.6%] in number followed by femur [n=12, 25.5%]. Majority [n=15, 31%] of the fractures were Type IIIA. All of the isolated MRSA cultures were 100% sensitive to vancomycin, linezolid, teicoplanin, chloramphenicol and tigecycline while resistance was observed for ciprofloxacin, levofloxacin, clarithromycin, and erythromycin
Conclusion: methicillin resistant staphylococcus aureus infection in open fracture wound is not uncommon. The isolated pathogen showed a variable pattern of sensitivity and resistance to the antibiotics tested