BACTERIOLOGICAL PROFILE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF OPEN FRACTURE WOUND ISOLATES IN UPPER AND LOWER LIMB: A STUDY FROM TERTIARY CARE CENTER OF THE SUB-HIMALAYAN REGION OF INDIA

Background: Open fractures are high-risk injuries prone to infection due to direct communication with the external environment. These injuries are often associated with high- energy trauma and require prompt surgical intervention and targeted antimicrobial therapy. Understanding the demographic distribution, mechanisms of injury, and microbiological spectrum is essential for effective management. Material and Method: This study is a retrospective analysis of the bacteriological profile and antimicrobial susceptibility pattern of open fracture wound isolates in upper and lower limb organisms over a period of 1year, i.e., from April 2023 to March 2024. All samples were processed as per standard Microbiological guidelines. Antimicrobial susceptibility was done by the Kirby-Bauer disk diffusion method as per CLSI guidelines. Results: Open fractures were more common in males (87%), with the 31–50 age group most affected. Road accidents were the leading cause (61%), mostly involving the lower limb (71%). Culture positivity was higher in lower limb fractures (28.2%) than in upper limbs (24.1%). Escherichia coli and Staphylococcus aureus were the predominant pathogens. Colistin and Vancomycin showed the highest sensitivity among Gram-negative and Gram- positive isolates, respectively. Discussion and conclusion: Lower limb open fractures are more prone to infection, with a broader spectrum of pathogens. The predominance of Escherichia coli and Staphylococcus aureus, along with varying antimicrobial resistance patterns, underscores the importance of regular microbiological surveillance and antibiotic stewardship in managing open fractures