title: A comparison of superficial and deep bacterial presence in open fractures of the lower extremities.
abstract: This open prospective study compared the bacterial flora of superficial and deep-wound biopsies and swabs over a 2-year period in 4 different samples cultured from open fracture wounds at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Samples were taken from 47 patients with factures graded according to Gustilo and Anderson's classification as grade 1 (2.1%), grade II (29.8%), grade IIIA (36.2%), and grade IIIB (31%). A total of 248 samples were cultured using standard techniques. The incidence of open fracture wounds was 78.7% in male patients and 21.3% in female patients. Tibia fractures constituted 66.1%. A total of 203 bacterial isolates were cultured from 248 samples. Gram-negative bacteria constituted 53.2% of isolates, with Escherichia coli being predominant (12.8%). Staphylococcus aureus were the predominant Gram-positive cocci (15.3%), and Staphylococcus epidermidis (13.3%) may be considered to be the major source of open fracture wound contamination. The bacterial species cultured from superficial and deep-wound swabs and biopsies were similar. Resistance to antimicrobials was high for penicillins (amoxicillin and cloxacillin), with values of 68.6% and 58.3%, respectively, for superficial bacterial species and 58.2% and 31.9%, respectively, for deep-wound biopsies.
authors.affiliation: Faculty of Science, Obafemi Awolowo University, Ile-Ife. Nigeria.
authors.forename: A K
authors.initials: AK
authors.lastname: Ako-Nai
authors.forename: I C
authors.initials: IC
authors.lastname: Ikem
authors.forename: F V
authors.initials: FV
authors.lastname: Daniel
authors.forename: D O
authors.initials: DO
authors.lastname: Ojo
authors.forename: L M
authors.initials: LM
authors.lastname: Oginni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D002648:Child; D005260:Female; D005597:Fractures, Open / Q000382:microbiology*; D006801:Humans; D007867:Leg Bones / Q000293:injuries*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D055815:Young Adult