Microbiological agents and their antimicrobial sensitivity patterns among patients with chronic osteomyelitis attending Mulago national referral and comprehensive rehabilitation services in Uganda hospitals

Abstract

Introduction: Chronic osteomyelitis remains a big problem in low resource settings. Surgery, with antimicrobial treatment guided by culture and sensitivity are the treatments of choice. Poor choice of antibiotics could partly be a reason for relapses in our setting since treatment is routinely not guided by culture and sensitivity. Objective: To describe the microbiological agents and their antimicrobial sensitivity patterns among patients with chronic osteomyelitis attending MNRH and CoRSU hospitals. Methods: This was a cross sectional study, carried out at MNRH and CoRSU hospitals between February 2020 and September 2020. Eighty five patients with chronic hematogenous osteomyelitis were consecutively recruited. Infected necrotic tissues, pus and or sequestrum from the affected long bone were taken for microscopy, culture and antimicrobial sensitivity profiling. Collected data was entered into electronic Epi Data version 4.2.0.0, and then exported to Stata Version 15 for analysis. Descriptive statistics were used to summarize the data. Results: Staphylococcus aureus (44.2%), Coagulase negative Staphylococcus aureus (16.3%) and Klebsiella pneumoniae (7.0%) were the most common microbiological agents isolated. Methicillin resistant Staphylococcus aureus (MRSA) accounted for 10.5% of all staphylococcus aureus isolates. Fungi and Mycobacterium tuberculosis constituted 3.5% and 1.2% respectively. Bacteria were highly sensitive to chloramphenicol, gentamycin, oxacillin, vancomycin, amikacin and meropenem. Bacterial resistance to penicillin and co-trimoxazole was very high. Conclusion: This study heights the importance of microbiological examinations in chronic osteomyelitis. Staphylococcus was the single most common pathogen isolated however Mycobacterium tuberculosis and fungi where also isolated in our setting. Bacterial resistance to penicillins and co-trimoxazole is very high in our setting.