title: Pathogenic bacteria in an orthopaedic hospital in India.
abstract: BACKGROUND
  The problem of changes in pathogenic microbiological flora and the emergence of bacterial resistance has created major problems in the management of orthopaedic diseases and fractures. Due to the use of implants for open reduction and internal fixation, which are foreign bodies to the body, orthopaedic trauma surgery is at grave risk of microbiological contamination and infection.
  
  
  METHODS
  With new microbiological agents in vogue, we have conducted a retrospective study to determine the pattern of bacterial infection, sensitivity to various antimicrobial agents, and their relations to various orthopaedic illnesses and procedures.
  
  
  RESULTS
  Gram negative (E. coli and Pseudomonas spp.) infections have emerged as the major threat (74.37%) in orthopaedic cases in contrast to Staphylococcus aureus (23.31%). These bacteria infected patients with open fractures (34.3%), spinal instrumentation with bedsores (23.31%), osteomyelitis of bone (24.42%) and guillotine amputation stumps (14.43%).
  
  
  CONCLUSIONS
  Cefaperazone and ceftriaxone were found to be the most effective antibiotics against gram negative bacteria while cefaperazone was equally effective against S. aureus. Emerging resistance was found against amoxicillin, ampicillin and the aminoglycoside: amikacin.
authors.affiliation: Department of Orthopaedics and Traumatology, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, M P, India. dralokcagrawal@yahoo.co.in
authors.forename: Alok C
authors.initials: AC
authors.lastname: Agrawal
authors.forename: Shuddhatma
authors.initials: S
authors.lastname: Jain
authors.forename: R K
authors.initials: RK
authors.lastname: Jain
authors.forename: H K T
authors.initials: HK
authors.lastname: Raza
mesh_terms: D000672:Amputation Stumps / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology*; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D019637:Orthopedic Procedures; D010019:Osteomyelitis / Q000382:microbiology; D003668:Pressure Ulcer / Q000382:microbiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology