Bacterial Pathogens And Antibiotic Resistance In Orthopaedic Implant-Related Infections: Challenges And Strategies For Effective Management

Abstract

Background: Orthopaedic implant-related infections (OIRI) cause significant clinical and therapeutic challenges, coupled with high morbidity and costs to patients as well as to healthcare systems. This study looked into the prevalence, risk factors, and the microbial profile of OIRI by identifying resistant strains and their associated clinical implications.

Methods: This was a one-year study conducted from July 2016 to June 2017 at Coimbatore Medical College, in which 137 clinically suspected OIRI cases were included. Culture positivity was assessed, and microbiological isolates were identified through phenotypic and molecular methods, including PCR for MRSA strains and ESBL testing for Gram-negative bacilli.

Results: Of 137 OIRI cases, 116 were culture-positive (85%). The commonest pathogens isolated were Staphylococcus aureus (77.2%) and Klebsiella spp. (34.4%). MRSA was isolated in 32.3% of Staphylococcus aureus isolates, while 22 Gram-negative isolates produced ESBL. The study also found diabetes mellitus, smoking, and alcoholism as major risk factors, with early onset of infection being predominant (76.6%). Emergency surgeries were also found to be associated with higher rates of infection.

Conclusion: OIRI is still a significant concern in orthopaedic practice, with some shifts in the patterns of microbial resistance, especially the emergence of MRSA and ESBL-producing strains. Preventive strategies, such as perioperative glycemic control and antibiotic prophylaxis, are essential in reducing infection rates. Accurate microbial surveillance and tailored antibiotic regimens based on local resistance trends are vital for improving patient outcomes.