Quantitative bacteriology-A predictor of risk of postoperative infection in open fractures

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Original Article

Author Details : Arthi K, Deepa R*, Mangala A

Volume : 5, Issue : 3, Year : 2018

Article Page : 421-424

https://doi.org/10.18231/2394-5478.2018.0087

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Abstract

Introduction: Quantitative Microbiology involves measurement of an absolute quantity of bacteria per unit of volume. The threshold to distinguish colonisation from infection is 10⁵ CFU/g. Quantitative cultures are used in predicting the risk of post operative infection.
Aim: To determine the role of quantitative bacteriology as a predictor of risk of infection in patients with open fractures.
Materials and Methods: One hundred patients who had sustained open fractures of long bones were included in the study. During debridement before antiseptic wash, a piece of tissue (muscle/skin) was collected under aseptic precautions for quantitative culture. A quantitative count of ? 10⁴cfu/gm was interpreted as significant microbial burden. These patients were followed up for 6 weeks for development of clinical signs of infection and two swabs were collected by Levine’s technique for semiquantitative culture.
Results: The preoperative culture of the debrided tissue of 41% yielded a microbial load of ?10⁴ cfu/gram among which 85.3% had 10⁵ cfu/gram of microbial load. Polymicrobial growth was reported in 12.2% of patients. Postoperatively 39% developed signs of infection Seventy one percent of patients with 10⁵ cfu/gram of microbial load in the preoperative period developed postoperative infection. All patients with polymicrobial growth in the preoperative debridement cultures with ?10⁴ cfu/gm of microbial load, developed infection in the postoperative period.
Conclusion: Quantitative Microbiology plays a precise role in predicting the risk of infection as it is valuable in estimating the bacterial bioburden. Polymicrobal etiology can lead to clinical infection if not managed effectively.

Keywords: Quantitative, Infection, Bioburden, Fracture, Debridement.

How to cite : Arthi K, Deepa R, Mangala A, Quantitative bacteriology-A predictor of risk of postoperative infection in open fractures. Indian J Microbiol Res 2018;5(3):421-424

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