title: The Role of MDR-Acinetobacter baumannii in Orthopedic Surgical Site Infections.
abstract: BACKGROUND
  Gram-positive microorganisms were the main causative organisms of orthopedic surgical site infections (SSI); however the rising incidence of multiple drug resistant Acinetobacter baumannii (MDR-AB) infections in orthopedic operations causes a great concern because of their limited array of therapeutic options.
  
  
  OBJECTIVE
  Our objective was to remark the changing microbiology in orthopedic SSI and to evaluate the MDR CHROMagar Acinetobacter media for screening of MDR-AB.
  
  
  METHODS
  Aspirated pus samples were collected from infected wounds of 100 patients in the orthopedics unit of El-Helal Hospital, samples were cultured on conventional media and MDR CHROMagar Acinetobacter media, the reveled MDR-AB colonies were subjected to polymerase chain reaction (PCR) to detect blaOXA-51 like gene.
  
  
  RESULTS
  Out of 100 infected wounds SSI cases represented 90/100 (90%) according to CDC 2013 definitions. Staphylococcus aureus was the dominant organism 40/90 (44.4%) (P value 0.038), all S. aureus isolates were methicillin-resistant Staphylococcus aureus (MRSA), followed by Klebsiella pneumoniae 22/90 (24.44%) and Acinetobacter 15/90 (16.67%). Implant was highly associated with SSI cases 80/90 (89%). Also, prolonged hospital stay>7 d was significantly associated with SSI 69/90 (77%) (p=0.001).
  
  
  CONCLUSIONS
  Staphylococcus aureus was the main causative organism of orthopedic SSI (44.4%), whereas A. baumannii represented only (16.67%) of the causative organisms. MDR Acinetobacter CHROMagar reduced the turnaround time for screening of MDR-AB.
authors.affiliation: Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt .
authors.forename: Sohier
authors.initials: S
authors.lastname: Helal
authors.affiliation: Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt .
authors.forename: Mervat
authors.initials: M
authors.lastname: El Anany
authors.affiliation: Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt .
authors.forename: Doaa
authors.initials: D
authors.lastname: Ghaith
authors.affiliation: Clinical and Chemical Pathology Department, Cairo University , Cairo, Egypt .
authors.forename: Samar
authors.initials: S
authors.lastname: Rabeea
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000302:isolation & purification; D001431:Bacteriological Techniques / Q000379:methods; D003470:Culture Media / Q000737:chemistry; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008403:Mass Screening / Q000379:methods; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D019637:Orthopedic Procedures / Q000009:adverse effects*; D016133:Polymerase Chain Reaction; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D003470:Culture Media; D004269:DNA, Bacterial; D001618:beta-Lactamases