PREVALENCE AND CHARACTERISTICS OF INFECTIONS DUE TO POSTTRAUMATIC ORTHOPAEDIC SURGERY IN A TERTIARY TEACHING HOSPITAL IN MALAYSIA

Abstract

Intro: Surgical site infections (SSIs), especially those caused by multidrugresistant organisms (MDROs) are a global public health issue as it sometimes causes serious complications. The focus of this study is to study the prevalence and the characteristics of SSI in patients who had undergone orthopaedic trauma surgeries. Methods: Patients over 18 years old that underwent orthopaedic surgery after having a motor-vehicle accident (MVA) between November 2020 and July 2021 were enrolled and monitored for any signs and symptoms of SSI for 30 days for surgeries without implants and 9 months for surgeries with implants. Clinical samples collected from SSI sites were identified and subjected to targeted multiplex sequencing to identify the antimicrobial resistance (AMR) conferring genes. Findings: From 126 patients that underwent surgery post-MVA, four developed SSI which is 3.1 per 100 procedures. Twenty-one bacterial strains were isolated. Fifteen bacterial strains were identified as MDRO including MDR Proteus mirabilis, MRCoNS, MRSA, VRE, and XDR Acinetobacter baumaniii. Susceptible strains (n = 6) of Pseudomonas aeruginosa were identified in two cases. Conclusion: Despite the fact that this study only reported four cases, we observed that MDROs were responsible for most SSI cases. The outcomes highlighted the importance of regular SSI surveillance, as well as the use of appropriate antibiotic stewardship and infection control measures, in order to prevent the incidence of SSI in post-trauma surgeries.