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KMID : 0371319640060100637
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Journal of the Korean Surgical Society
1964 Volume.6 No. 10 p.637 ~ p.644
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Bacteriological Considerations of Orthopdic Infections
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文命相/Moon, Myung Sang
李德鏞/韓文植/Lee, Duk Yong/Han, Moon Sik
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Abstract
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88 cases of orthopedic infections with positive cultures treated at the Orthopedic Service of Seoul National University Hospital are reviewed and the etiological agents(offending organisms)are discussed with particular reference to the emergence of drug-resistant strains. Included among those are 63 cases of osteomrelitis, 50 acute(92%) and 5 chronic(8%), 14 cases of traumatic wound infection, 3 cases of septic arthritis, and 5 cases of acute suppurative myositis and abscesses. 117 different strains were found comprising 12 bacterial genera; of these one etiological agent(genus) was found in 68 cases, 2 agents in 16 cases, and 3 agents in 4 cases. Etiological agents in 63 cases of osteomyelitis were as follows: staphylococcus 90.4%, hemolytic streptococus 11.1%, paracolon bacillus 7.9%, pseudomonas 4.7%, alcaligenes 3.2%, E. coli 1.6%, proteus 1.6%, and corynebacterium 1.6%.
A single disk technique for bacteriological antibiotic sensitivity testing has provided the data upon which this report is based. Data concerning susceptibility of staphylococci to a series of commonly used antibiotics, tested at Seoul National University Hospital from July 1962 to Dec. 1969. are compared with sensitivity reports from other series.
There seemingly is a trend of increase of the staphylococcus as an etiologic agent in osteomyelitis while the streptococcus has been on the decreaae since the advent and widespread use of antibiotics. There is also a trend of gragual increase of drug-resistant Gram-negative bacilli, such as paracolon bacilli, alcaligenes, and colon bacilli, as etiologic agents in orthopedic infections. This is particularly true of wound infection in which pseudomonas seem to prevail. Statistics in our series were generally in accord with those of the world literature, although the incidence of streptococcal infection was slightly higher than that reflected in the latest reports.
At present, penicillin and streptomycin have become unreliable to use prophylactically while chloramphenicol, tetracycline, oxytetracycline are gradually losing their reliability for prophylaxis.
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