Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study.
Mark L VickersEmma L BallardPatrick N A HarrisLuke D KnibbsAnjali JaiprakashJoel M DulhuntyRoss W CrawfordBenjamin ParkinsonPublished in: International journal of environmental research and public health (2020)
We aimed to describe the epidemiology, multi-drug resistance and seasonal distribution of bacteria cultured within 12 months following lower limb orthopaedic surgery in tropical and subtropical Australian hospitals between 2010 and 2017. We collected data from four tropical and two subtropical hospitals. Categorical variables were examined using the Pearson Chi-squared test or Fisher's Exact test, and continuous variables with the Student t-test or Mann-Whitney U test. A Poisson regression model was used to examine the relationship between season, weather and the incidence of Staphylococcus and nonfermentative species. We found that at tropical sites, nonfermenters (Pseudomonas aeruginosa and Acinetobacter baumannii) were more common (28.7% vs. 21.6%, p = 0.018), and patients were more likely to culture multi-drug-resistant (MDR) nonfermenters (11.4% vs. 1.3%, p = 0.009) and MDR Staphylococcus aureus (35.9% vs. 24.6%, p = 0.006). At tropical sites, patients were more likely to be younger (65.9 years vs. 72.0, p = < 0.001), male (57.7% vs. 47.8%, p = 0.005), having knee surgery (45.3% vs. 34.5%, p = 0.002) and undergoing primary procedures (85.0% vs. 73.0%, p = < 0.001). Species were similar between seasons in both tropical and subtropical hospitals. Overall, we found that following lower limb orthopaedic surgery in tropical compared with subtropical Australia, patients were more likely to culture nonfermenters and some MDR species.
Keyphrases
- lower limb
- drug resistant
- acinetobacter baumannii
- multidrug resistant
- end stage renal disease
- climate change
- minimally invasive
- pseudomonas aeruginosa
- staphylococcus aureus
- ejection fraction
- chronic kidney disease
- newly diagnosed
- healthcare
- peritoneal dialysis
- coronary artery bypass
- risk factors
- cystic fibrosis
- biofilm formation
- coronary artery disease
- endothelial cells
- surgical site infection
- machine learning
- patient reported outcomes
- knee osteoarthritis
- artificial intelligence
- candida albicans
- percutaneous coronary intervention