Bacterial Profile, Multi-Drug Resistance and Seasonality Following Lower Limb Orthopaedic Surgery in Tropical and Subtropical Australian Hospitals: An Epidemiological Cohort Study

Mark L. Vickers, Emma L. Ballard, Patrick N. A. Harris, Luke D. Knibbs, Anjali Jaiprakash, Joel M. Dulhunty, Ross W. Crawford and Benjamin Parkinson
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Mark L. Vickers: Biomedical Engineering and Clinical Sciences, Queensland University of Technology, Brisbane 4000, Australia
Emma L. Ballard: QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
Patrick N. A. Harris: UQ Centre for Clinical Research, The University of Queensland, Brisbane 4006, Australia
Luke D. Knibbs: School of Public Health, The University of Queensland, Brisbane 4006, Australia
Anjali Jaiprakash: Science and Engineering Faculty, Queensland University of Technology, Brisbane 4000, Australia
Joel M. Dulhunty: School of Public Health and Social Work, Queensland University of Technology, Brisbane 4006, Australia
Ross W. Crawford: Biomedical Engineering and Clinical Sciences, Queensland University of Technology, Brisbane 4000, Australia
Benjamin Parkinson: Department of Orthopaedics, Cairns Base Hospital, Cairns 4870, Australia

IJERPH, 2020, vol. 17, issue 2, 1-15

Abstract: 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.

Keywords: orthopaedics; multiple drug resistance; bacteria; antibacterial agents; epidemiology (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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