Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isol...Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isolates in post-operative wound infections in a tertiary care hospital in Kathmandu,Nepal. Pus swabs collected from post-operative wound infections and submitted for culture and sensitivity were included in this study. Isolation and identification of the organism was done by standard microbiological methods. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and result was interpreted as per National Committee for Clinical Laboratory Standards (NCCLS) guide lines. Of the 120 pus swabs processed for culture, 96 showed bacterial growth. Staphylococcus aureus 36 (37.5%) was the predominant gram positive isolate and Escherichia coli 24 (25%) was the major gram negative isolate .The infection was most prevalent in the age group 20-40 years. All S. aureus isolates were sensitive to aminoglycosides and vancomycin. Out of 36 S. aureus, 15 (41.66%) isolates were methicillin resistant S. aureus (MRSA). Staphylococcus epidermidis showed high resistance (50%-100%) to all antibiotics but were sensitive to vancomycin. All gram negative isolates showed high resistance against cephalexin (75%-100%) and ceftriaxone (25%-100%). Overall multi-drug resistant isolates were 66.7%. A high level of AMR was observed in gram negative bacterial isolates. Rational use of antibiotics and a regular monitoring of AMR patterns in post-operative wound infections are essential and mandatory to avert further emergence and spread of anti-microbial resistance among bacterial pathogens.展开更多
In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable the...In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable therapeutic challenges throughout the history of fracture treatment. Most of these surgical failures were due to inadequate fixation of the fracture fragments. The Aim of the study is to determine whether distal femur locking plates are superior implants than dynamic condylar screw and distal femur nail. A prospective and observational study was done in Department of Orthopaedics and Traumatology, Sri Ramachandra Medical Collage, Chennai between Jan. 2011 and Jan. 2015. Patients with distal femoral fractures, admitted into the hospital, were treated using various modes of internal fixation and followed up over a period of six months to one year and their functional outcome was evaluated. The functional and radiological assessment of patients during follow-up was done using Neer’s criteria. The use of any one of the implant, i.e. distal femur locking plates, dynamic condylar screw or distal femur nailing for internal fixation, depends on the type of fracture and the pre operative planning and intra operate decision of the surgeon. In our study, 38% of fractures treated by Dynamic condylar screw, 72% of fractures treated by distal femur locking plate and 42% of fractures treated by Distal femur supracondylar nail had excellent/satisfactory results. Locking plates had better outcome in both extra-articular and intra-articular group. They also had better outcome in both younger and older age groups.展开更多
文摘Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isolates in post-operative wound infections in a tertiary care hospital in Kathmandu,Nepal. Pus swabs collected from post-operative wound infections and submitted for culture and sensitivity were included in this study. Isolation and identification of the organism was done by standard microbiological methods. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and result was interpreted as per National Committee for Clinical Laboratory Standards (NCCLS) guide lines. Of the 120 pus swabs processed for culture, 96 showed bacterial growth. Staphylococcus aureus 36 (37.5%) was the predominant gram positive isolate and Escherichia coli 24 (25%) was the major gram negative isolate .The infection was most prevalent in the age group 20-40 years. All S. aureus isolates were sensitive to aminoglycosides and vancomycin. Out of 36 S. aureus, 15 (41.66%) isolates were methicillin resistant S. aureus (MRSA). Staphylococcus epidermidis showed high resistance (50%-100%) to all antibiotics but were sensitive to vancomycin. All gram negative isolates showed high resistance against cephalexin (75%-100%) and ceftriaxone (25%-100%). Overall multi-drug resistant isolates were 66.7%. A high level of AMR was observed in gram negative bacterial isolates. Rational use of antibiotics and a regular monitoring of AMR patterns in post-operative wound infections are essential and mandatory to avert further emergence and spread of anti-microbial resistance among bacterial pathogens.
文摘In spite of advances in techniques and improvements in surgical implants, confusion still prevails regarding use of specific implants in distal femur fracture. Fractures in the distal femur have posed considerable therapeutic challenges throughout the history of fracture treatment. Most of these surgical failures were due to inadequate fixation of the fracture fragments. The Aim of the study is to determine whether distal femur locking plates are superior implants than dynamic condylar screw and distal femur nail. A prospective and observational study was done in Department of Orthopaedics and Traumatology, Sri Ramachandra Medical Collage, Chennai between Jan. 2011 and Jan. 2015. Patients with distal femoral fractures, admitted into the hospital, were treated using various modes of internal fixation and followed up over a period of six months to one year and their functional outcome was evaluated. The functional and radiological assessment of patients during follow-up was done using Neer’s criteria. The use of any one of the implant, i.e. distal femur locking plates, dynamic condylar screw or distal femur nailing for internal fixation, depends on the type of fracture and the pre operative planning and intra operate decision of the surgeon. In our study, 38% of fractures treated by Dynamic condylar screw, 72% of fractures treated by distal femur locking plate and 42% of fractures treated by Distal femur supracondylar nail had excellent/satisfactory results. Locking plates had better outcome in both extra-articular and intra-articular group. They also had better outcome in both younger and older age groups.
