Pathogenic Bacteria Associated with Open Fracture Wounds: Isolation and Microbiological Analysis

In this study, a total of 145 samples were collected from patients with open fracture wounds attending the orthopedic consultation clinics and inpatient wards at Al-Jumhuri Teaching Hospital and Al-Salam Hospital in Mosul City. The samples were cultured on selective media, and bacterial isolates were identified based on morphological and cultural characteristics, biochemical tests, and the Analytical Profile Index 20 Enterobacteriaceae system )API 20E system(.Antimicrobial susceptibility of the bacterial isolates was evaluated using the disk diffusion method. A total of 137 bacterial isolates were recovered, representing 94.5% of the total samples. Among the Gram-positive bacteria, Staphylococcus aureus was the most frequently isolated species, accounting for 50.9%. Among the Gram-negative bacteria, Pseudomonas aeruginosa was the predominant isolate, representing 30.8%. The isolation rates of other bacterial species varied. The study revealed that the incidence of infections was higher in males (76%) than in females (24.1%), and higher in urban areas (77%) compared to rural areas (23%). Lower limb injuries were more frequent (69.3%) than upper limb injuries (30.7%). The patients were categorized into six age groups, with the age group of 18–34 years showing the highest susceptibility to infection (60%). According to the Gustilo and Anderson classification system, the majority of the cases were classified as Type II (35.2%). Antibiotic susceptibility testing showed that Gram-negative isolates exhibited complete sensitivity to Imipenem. However, these isolates demonstrated high resistance to Amoxicillin-clavulanic acid, Rifampin, Amoxicillin, and Carbenicillin. Gram-positive bacteria were 100% sensitive to Vancomycin and highly sensitive to Rifampin, while exhibiting high resistance to Cefepime.