Evidence map›Paper›PMID 39891873›Full record

ArticleMusculoskeletal surgery2025

Is routine Gram-negative antibiotic coverage required for optimum antibiotic prophylaxis in open reduction and internal fixation of fractures? A multicenter analysis of bacteria pathogens in fracture-related infections.

O M Shodipo, A S Arojuraye, A M Ramat, M J Balogun, L O Ajiboye, S S Ibrahim, W I Aremu, K A Alatishe, C M Akah, O A Lasebikan

Abstract readMulticenter Study
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In one paragraph

Article in Musculoskeletal surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

O M ShodipoOrthopaedic Unit, Department of Surgery, Federal Medical Centre, P.M.B. 14, Bida, Niger State, Nigeria. drshodipo@gmail.com.ORCID http://orcid.org/0000-0002-5491-2190
A S ArojurayeDepartment of Orthopaedics, National Orthopaedic Hospital, Dala, Kano State, Nigeria.
A M RamatDepartment of Orthopaedics, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
M J BalogunDepartment of Orthopaedics, University College Hospital, Ibadan, Oyo State, Nigeria.
L O AjiboyeDepartment of Orthopaedics, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria.
S S IbrahimDepartment of Orthopaedics, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Bauchi State, Nigeria.
W I AremuDepartment of Orthopaedics and Trauma, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria.
K A AlatisheDepartment of Orthopaedics, National Orthopaedic Hospital, Igbobi, Lagos State, Nigeria.
C M AkahDepartment of Orthopaedic Surgery, National Orthopaedic Hospital, Enugu, Enugu State, Nigeria.
O A LasebikanDepartment of Orthopaedic Surgery, Federal Medical Centre, Ebute Metta, Lagos State, Nigeria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMeasures directed at infection prevention, particularly perioperative systemic antibiotic prophylaxis, have received widespread implementation and are considered a standard of care for patients undergoing operative management of fractures, especially with implant use. This study aimed to review the microbiology profile of patients with fracture-related infections (FRIs) in a sub-Saharan African country in order to establish the necessity or otherwise of Gram-negative cover in the selection of antibiotics for perioperative prophylaxis. METHODOLOGY: This study retrospectively reviewed records of adult patients (aged 18 years and above) diagnosed with FRI from January 2018 to December 2022 in ten tertiary hospitals in Nigeria. Data related to demographics, fracture and FRI classification as well as pathogenic bacteria were obtained while data were analyzed with SPSS version 23.

resultsOver the study period, 137 cases met the inclusion criteria and their data were obtained for analysis. Gram-positive and Gram-negative bacteria species accounted for 70 (51%) and 67 (49%), respectively, of the entire microorganisms identified by bacteriological culture. The most common organisms isolated from culture include Staphylococcus aureus (62, 45.3%), Escherichia coli (29, 21.2%), Klebsiella pneumonia (17, 12.4%) and Pseudomonas aeruginosa (11, 8.1%). The distribution of pathogenic bacteria isolated from positive cultures of infected closed and open fractures revealed a predominance of Gram-negative bacteria in closed fractures accounting for 45(55.6%) of the 81 organisms isolated; however, Gram-negative organisms accounted for only 22 (39.3%) of the 56 organisms isolated in open fractures (P = 0.061).

conclusionThe findings in this study suggest that Gram-negative cover may be necessary for optimal perioperative antibiotic coverage, particularly in the sub-Saharan Africa setting in patients undergoing internal fixation of fractures. We recommend that individual institutions should establish local prophylactic protocols that provide Gram-positive and Gram-negative pathogen coverage guided by local microbiological flora.

Indexed as

Anti-Bacterial AgentsAntibiotic ProphylaxisFracture Fixation, InternalGram-Negative BacteriaGram-Negative Bacterial InfectionsOpen Fracture ReductionSurgical Wound InfectionAdultAgedFemaleFractures, BoneHumansMaleMiddle AgedNigeriaRetrospective StudiesAnti-Bacterial AgentsAntibiotic prophylaxisFracture-related infectionsGram-negative bacteriaGram-positive bacteria

Identifiers

PMID39891873

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