Clinico-microbilogical Profile of Chronic Osteomyelitis in a Tertiary Care Hospital of North India

Abstract

Aims: Chronic osteomyelitis is an important clinical entity in patients with bone infections and is associated with great morbidity especially in developing countries. It is a persistent disease, difficult to treat and eradicate completely. Early identification and diagnosis of osteomyelitis has led to the improved management of osteomyelitis. This study was undertaken to determine the bacteriological profile of osteomyelitis and the antibiotic resistance pattern of various isolates obtained. Study Design: It was a prospective cross-sectional hospital based study. Place and Duration of Study: The present study was conducted in the Department of Microbiology, Government Medical College, Srinagar, from January 2019 to December 2019. Methodology: In all, 208 patients with chronic osteomyelitis were documented during the study period. Clinical specimens like pus, pus swabs, sequestrum of bone and synovial fluid were taken and cultured aerobically .The samples were processed using standard microbiological techniques. Identification and antimicrobial susceptibility pattern of the bacterial isolates were done using the Vitek 2 (bioMerieux, France) system. Results: A total of 208 samples were received out of which, 91 (43.75%) were positive by culture. Out of the 91 positive samples, Staphylococcus aureus 65 (64.2%) was the most commonly isolated pathogen and 67.6% of Staphylococcus aureus were MRSA. Other important organisms isolated included Acinetobacter sp (10.98%), E. coli (6.59%), Proteus mirabilis (4.3%), Pseudomonas aeruginosa (2.1%) and Klebsiella pneumoniae (2.1%). All the isolates of Staphylococcus aureus were resistant to Penicillin. However, Vancomycin resistance was not detected in any of the patients with MRSA. All Gram negative bacilli were sensitive to Colistin. Conclusion: The wide range of causative organisms and degree of resistance to commonly used anti- microbials supports the importance of pus culture and provides important information to guide clinician’s choice of empirical antibiotics. Appropriate selection of antibiotic would help to treat the disease successfully and limit the emergence of drug resistant strains to prevent morbidity & mortality.