DOI: 10.5061/dryad.h18931zt2
title: Orthopaedic surgical site infections: Prevalence, bacterial etiology, and antimicrobial resistance

description: Background: Surgical site infections (SSIs), the second most dreaded
 post-operative hospital-acquired infection, play an important role in the
 emergence of multi-drug-resistant (MDR) bacteria owing to the practice of
 prophylactic antibiotic use. Even in the most advanced hospitals, SSIs are
 becoming more common, yet limited literature exists on the bacteriological
 profile and antimicrobial resistance. This cross-sectional study assessed
 the prevalence of orthopaedic SSIs in traumatically operated patients’
 one-month post-operation in correlation to antibiotic resistance in
 bacteria-causing SSIs. Method: The demographic and surgical records of
 orthopaedic patients suffering post-operative SSI (clean or
 clean-contaminated wound) and examined in the Department of Microbiology,
 National Trauma Center, for aerobic bacteriological culture and
 susceptibility testing during three years (2020-2022) were analyzed with
 SPSS version 17.0. Results: Among the total patients (n=1,438), 448
 (median age: 35 years; males: 341) developed SSIs, with knee/joint
 infections (141/448) being predominant. SSIs occurred every seven days on
 average. Staphylococcus aureus (216/448) was the predominant bacteria.
 Overall, 61.88% (250/404) of isolates were penicillin-resistant, whereas
 51.31% (450/877) were cephalosporin-resistant. Streptococcus spp.
 and Enterobacter spp. were equally predominant MDR (50%)
 and extensively drug-resistant (XDR) isolates (25%), while S.
 aureus was the predominant pan-drug-resistant isolate
 (0.46%). Fluoroquinolone resistance rates in non-MDR (n=272), MDR
 (n=153), and XDR (n=22) were 15.88%, 60.59%, and 22.94%, respectively,
 while aminoglycoside resistance rates were 13.27%, 59.29%, and 24.49%.
 Acinetobacter calcoaceticus baumanii complex exhibited the highest
 multiple antibiotic resistance index (0.58). Conclusion: SSIs following
 orthopaedic procedures were highly prevalent, particularly due to S.
 aureus and MDR strains. Antibiotic resistance was more pronounced in MDR
 strains, encompassing XDR strains, than in non-MDR strains.
description: Patient-related information (age and gender) and surgical-related
 information [sites and types of fracture, length (days) to develop
 postoperative infections, type of wound (clean, clean-contaminated,
 contaminated, or dirty-contaminated), bacterial strain, and antibiotic
 susceptibility pattern] were collected between January
 20<sup>th</sup> and February 27<sup>th</sup>,
 2023, from the hospital's electronic database. Collected data were
 assessed for statistical analyses between March 6<sup>th</sup>
 and March 28<sup>th</sup>, 2023. The
 Statistical Package for Social Sciences, version 17.0 (SPSS Inc., Chicago,
 IL, USA), was used to import the exported data from Midas into Microsoft
 Excel version 10.0. The categorical variables were analyzed using
 frequencies and percentages in descriptive analysis. The median and
 interquartile ranges of patients' ages and lengths of postoperative
 infections were calculated. For two groups, the independent student t-test
 and chi-squared test were used to compare the strength of the associations
 between the quantitative (age) and qualitative (gender, year, season,
 month, surgical site, bacteria, antibiotic, and resistance) variables,
 respectively. <em>P</em>-values &lt;0.05 were considered
 significant.
description: # Orthopaedic surgical site infections: prevalence, bacterial etiology,
 and antimicrobial resistance
 The dataset is of
 orthopaedic surgical site infections (SSIs) in traumatically operated
 patients’ one-month post-operation along with antibiotic susceptibility
 profiles of bacteria-causing SSIs. Dataset comprises single sheet. The
 sheet details for demographic information, such as age and gender of the
 orthopaedic patients; clinical information, including fractures;
 microbiological findings comprising bacterial genera, antimicrobial
 resistance patterns, multi-drug-resistant or non-multi-drug-resistant,
 extesnsively-drug-resistant or non-extesnsively-drug-resistant. Exact age
 is removed and is categorized as age group in order to anonymize the data.
 Data were anonymized with the code. Orthopaedic patients with bacterial
 infections were coded with serial number (1, 23, etc.). Units of the study
 variables were standard and as follows: (a) Age group Years (b) Post
 operative time for infections Days Antimicrobial susceptibility testing
 was done with Kirby Bauer Disc Diffusion method. Except for values of post
 operative days for infections, the data were qualitative and were
 calculated as frequency (percentage) in SPSS version 17.0. Qualitative
 variables were tested using chi-square test at 95% confidence interval.
 S.N represents serial number, ACB complex represnts Acinetobacter
 calcoaceticus-baumannii complex, CoNS represents Coagulase-negative
 Staphylococcus, spp. represents species, n/a represents not available.
 Readers may access the data from the Dryad repository or with a request
 email to the corresponding author, Pramod Joshi
 (), of the article.