microbiological profile and drug resistance in bone and joint infections: a survey in orthopedic wards of a great referral hospital in tehran, iran

Background: patients undergoing orthopedic surgery are at risk of nosocomial infections, and antibiotic resistance is known to increase the risk of such infections.objectives: we aimed to determine the rate of antibiotic resistance in patients admitted to orthopedic wards in one of the largest referral hospitals in iran. we also ascertained responsible antibiotic-resistant microorganisms in patients with bone and joint infections.methods: the present cross-sectional investigation was concluded over a period of five years, from march 2018 to february 2023, at a great referral hospital in tehran. laboratory data, including the organisms isolated and their antibiotic resistance patterns, were collected by reviewing the hospital information system.results: in total, 2650 specimens obtained from patients with suspected bacterial infections were transferred to the hospital’s laboratory, 880 (33.2%) of which were positive for bacterial infections. the maximum antibiotic resistance rate against an antibiotic was observed to be 58% for staphylococcus aureus (erythromycin), 75% for klebsiella pneumonia (ampicillin/sulbactam), 64.5% for escherichia coli (imipenem), 76.2% for coagulase-negative staphylococcus (vancomycin), 100% for acinetobacter baumannii (imipenem), 52% for s. epidermidis (erythromycin), 85.9% for enterobacter species (gentamycin), and 65.6% for pseudomonas aeruginosa (ampicillin/sulbactam). the overall rate of multi-drug resistance was obtained as 27.6%.conclusions: a high rate of resistance of various bacterial strains to common antibiotics, especially erythromycin, ampicillin, imipenem, vancomycin, and gentamycin, was denoted in orthopedic wards. also, a high rate of multi-antibiotic resistance was encountered in these wards, where more than a quarter of the bacterial strains showed such resistance.