Antimicrobial Susceptibility Pattern of Bacteria Isolated from Prosthetic Device Used by Patients at National Orthopedic Hospital Enugu

Background: Prosthetic device-associated infections, frequently complicated by antimicrobial resistance (AMR), pose a severe clinical challenge. In Nigeria, limited regional data on pathogen prevalence and susceptibility impairs effective treatment. This study aimed to identify the primary bacterial agents and their resistance profiles in prosthetic infections at a major Nigerian orthopedic hospital. Methods: A cross-sectional study was conducted from June to November 2024 at the National Orthopedic Hospital, Enugu, Nigeria. One hundred samples from patients with clinical signs of infection post-prosthetic implantation were analyzed. Bacterial pathogens were identified via standard culture, and antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method. Results: Bacterial growth was confirmed in 65% of samples (n=65). Staphylococcus aureus was the predominant pathogen (38.5%), followed by Escherichia coli (23.1%) and Pseudomonas aeruginosa (15.4%). Susceptibility testing revealed alarmingly high resistance to common antibiotics, with 76.9% of isolates resistant to Erythromycin and 69.2% to Amoxicillin-Clavulanate. Conversely, Levofloxacin and Meropenem demonstrated the highest efficacy, with sensitivity rates of 76.9% and 69.2%, respectively. Infections were significantly more prevalent in males (p=0.030) and the 30–60-year age group (p=0.050). Conclusion: This study confirms a high prevalence of multidrug-resistant pathogens, led by S. aureus, in prosthetic device infections in Enugu. The findings highlight the inadequacy of empirical therapies using common antibiotics and strongly support the use of fluoroquinolones or carbapenems. These results underscore the urgent need for enhanced infection control, antibiotic stewardship, and routine surveillance to combat AMR.