Superficial swab cultures in open fracture management: insights from a resource-poor setting.

Objective: To identify bacterial isolates from superficial swabs of open fracture wounds at presentation and after infection has been established, and to determine if there are correlations between them. Method: Patients who presented with open fractures at the Wesley Guild Hospital, Ilesa, Nigeria...

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Published in:Journal of Wound Care Vol. 19; no. 10; pp. 432 - 439
Main Authors: Ojo O, Oluwadiya K, Ikem I, Oginni L, Ako-Nai A, Daniel F
Format: research tables/charts Journal Article
Published: Mark Allen Holdings Limited Oct2010
Online Access:View this record in EBSCOhost
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      dt: Oct2010
      vid: 19
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      pub: Mark Allen Holdings Limited
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        10.12968/jowc.2010.19.10.79090
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        atl: Superficial swab cultures in open fracture management: insights from a resource-poor setting.
      aug:
        au:
          Ojo O
          Oluwadiya K
          Ikem I
          Oginni L
          Ako-Nai A
          Daniel F
        affil: Consultant Orthopedic Surgeon, Department of Surgery, Federal Medical Centre, Ido-Ekiti, Nigeria
      sug:
        subj:
          Fractures
          Infection Prevention and Control
          Trauma
          Microbial Culture and Sensitivity Tests
          Nigeria
          Confidence Intervals
          Fractures Classification
          Prospective Studies
          Bacteria
          Data Analysis Software
          T-Tests
          Equipment and Supplies
      ab: Objective: To identify bacterial isolates from superficial swabs of open fracture wounds at presentation and after infection has been established, and to determine if there are correlations between them. Method: Patients who presented with open fractures at the Wesley Guild Hospital, Ilesa, Nigeria between December 2004 and May 2006 were recruited into this prospective study. Superficial wound swabs were taken at presentation and if patient showed evidence of wound infection. Results: Sixty patients had open fractures. The initial bacteria culture of wound swabs taken on the day of presentation was positive in 41 (68.3%) patients. Of these, 19 (46.3%) yielded one bacteria isolate, 17 (41.5%) yielded two and 5 (12.2%) yielded three, making a total of 68 organisms. The most common organism was Staphylococcus aureus. However, as a group, more aerobic Gram-negative rods were isolated than any other bacteria groups. Eleven (18.3%) patients developed wound infections, all of which were polymicrobial. In 10 (90.9%) of these, the microbial isolate of the final wound swab included at least one organism that was present in the initial wound culture. No patient with an initial negative culture went on to develop a wound infection. The mean presentation interval of patients with wounds that became infected was 15.2 ± 7.9 hours (95% CI 9.8-20.5 hours) compared with 2.9 ± 3.1 hours (95% CI 2.0-3.8 hours) for those who did not develop a wound infection (p>0.01). Conclusion: In a resource-poor setting, where pre-hospital care is unavailable and patients present late, superficial wound swabs are effective in predicting subsequent organisms that may cause wound infections.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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