Microbiological Profile and Antimicrobial Resistance Patterns Among Orthopedic Patients at a Tertiary Care Centre in Uttarakhand, India
- 1Pharmacology, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Uttarakhand, IND
- 2Orthopedics, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Uttarakhand, IND
- 3Medical Microbiology, N. K. P. Salve Institute of Medical Sciences & Research Centre and Lata Mangeshkar Hospital, Nagpur, IND
Abstract
Background
Antimicrobial resistance has complicated the management of bacterial infections among patients admitted to orthopedic wards by limiting effective treatment options and increasing the risk of treatment failure and prolonged hospitalization. This study aimed to describe the distribution of bacterial isolates and antimicrobial susceptibility patterns among patients admitted to an orthopedic ward and to identify clinical factors associated with multidrug-resistant (MDR) isolates.
Methods
This hospital-based cross-sectional study included 96 patients admitted to the orthopedic ward who had culture-positive clinical specimens and met the study eligibility criteria. Demographic and clinical characteristics, specimen types, bacterial isolates, previous antibiotic exposure, hospitalization history, implant status, and antimicrobial susceptibility profiles were recorded. MDR was defined as non-susceptibility to at least one agent in three or more antimicrobial categories.
Results
The mean age of the patients was 49.4 ± 18.8 years, and 58 (60.4%) were male. Urine was the most common specimen, comprising 50 (52.1%) samples. Escherichia coli was the predominant isolate, identified in 28 (29.2%) patients, followed by Staphylococcus aureus in 20 (20.8%). High rates of resistance were observed to cefazolin, cefepime, ciprofloxacin, and trimethoprim-sulfamethoxazole. MDR isolates were identified in 42 (43.8%) patients. MDR isolation was significantly associated with age >60 years, diabetes mellitus, orthopedic implant status, previous antibiotic exposure, previous hospitalization, and Gram-negative isolates. After adjustment for potential confounders, previous antibiotic exposure (adjusted OR=3.12, 95% CI: 1.20-8.16; p=0.020) and previous hospitalization (adjusted OR=2.73, 95% CI: 1.00-7.41; p=0.049) remained independently associated with MDR isolation. Patients with MDR isolates had a longer mean hospital stay than those without MDR isolates (14.1 ± 5.8 versus 8.9 ± 4.5 days; p<0.001); however, the cross-sectional design precludes determination of the temporal direction of this association.
Conclusions
Antimicrobial resistance and MDR isolates were common among patients admitted to the orthopedic ward. Previous antibiotic exposure and hospitalization were independently associated with MDR isolation, highlighting the importance of antimicrobial stewardship and appropriate microbiological evaluation in this population.
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BibTeX
@article{rd2026microbiological,
title = {{Microbiological Profile and Antimicrobial Resistance Patterns Among Orthopedic Patients at a Tertiary Care Centre in Uttarakhand, India}},
author = {Diwakar R.D. and Rajendra Sharma and Sunita Pandita and Daya Krishna and Kalpana P Date},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117496},
url = {https://doi.org/10.7759/cureus.117496},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Microbiological Profile and Antimicrobial Resistance Patterns Among Orthopedic Patients at a Tertiary Care Centre in Uttarakhand, India
AU - Diwakar R.D.
AU - Rajendra Sharma
AU - Sunita Pandita
AU - Daya Krishna
AU - Kalpana P Date
PY - 2026
DA - 2026/10/05
JO - Cureus
DO - 10.7759/cureus.117496
UR - https://doi.org/10.7759/cureus.117496
AB - Background Antimicrobial resistance has complicated the management of bacterial infections among patients admitted to orthopedic wards by limiting effective treatment options and increasing the risk of treatment failure and prolonged hospitalization. This study aimed to describe the distribution of bacterial isolates and antimicrobial susceptibility patterns among patients admitted to an orthopedic ward and to identify clinical factors associated with multidrug-resistant (MDR) isolates. Methods This hospital-based cross-sectional study included 96 patients admitted to the orthopedic ward who had culture-positive clinical specimens and met the study eligibility criteria. Demographic and clinical characteristics, specimen types, bacterial isolates, previous antibiotic exposure, hospitalization history, implant status, and antimicrobial susceptibility profiles were recorded. MDR was defined as non-susceptibility to at least one agent in three or more antimicrobial categories. Results The mean age of the patients was 49.4 ± 18.8 years, and 58 (60.4%) were male. Urine was the most common specimen, comprising 50 (52.1%) samples. Escherichia coli was the predominant isolate, identified in 28 (29.2%) patients, followed by Staphylococcus aureus in 20 (20.8%). High rates of resistance were observed to cefazolin, cefepime, ciprofloxacin, and trimethoprim-sulfamethoxazole. MDR isolates were identified in 42 (43.8%) patients. MDR isolation was significantly associated with age >60 years, diabetes mellitus, orthopedic implant status, previous antibiotic exposure, previous hospitalization, and Gram-negative isolates. After adjustment for potential confounders, previous antibiotic exposure (adjusted OR=3.12, 95% CI: 1.20-8.16; p=0.020) and previous hospitalization (adjusted OR=2.73, 95% CI: 1.00-7.41; p=0.049) remained independently associated with MDR isolation. Patients with MDR isolates had a longer mean hospital stay than those without MDR isolates (14.1 ± 5.8 versus 8.9 ± 4.5 days; p<0.001); however, the cross-sectional design precludes determination of the temporal direction of this association. Conclusions Antimicrobial resistance and MDR isolates were common among patients admitted to the orthopedic ward. Previous antibiotic exposure and hospitalization were independently associated with MDR isolation, highlighting the importance of antimicrobial stewardship and appropriate microbiological evaluation in this population.
SN - 2168-8184
ER -