A Study on Bacterial and Fungal Isolates and their Antimicrobial susceptibility pattern in patients with Chronic Osteomyelitis in a Tertiary Care Hospital.

INTRODUCTION : The word Osteomyelitis is a combination of Greek word “Osteon” Meaning bone and “Myelos” meaning marrow plus the suffix “Itis” meaning Inflammation. Osteomyelitis is acquired in three ways. They are direct seeding of Microorganisms into bone due to trauma or surgery, haematogenous spread of Microorganisms from the focus of infection elsewhere in the body and spread From surrounding infected soft tissues and joints In the infected bone, the infection may be unifocal or multifocal. In Unifocal involvement, only a single region of t he bone is affected. In Multifocal involvement, more than one region of bone such as marrow, Periosteum, cortex and the surrounding so ft tissue are involved. Commonly t he infect ion is mono microbial. Infect ion due to multiple Organisms are usually seen in patients with Diabetes mellitus with ulcer In the foot. Chronic Osteomyelitis of long bones is often the consequence of an Open, comminuted fracture and inadequately treated infect ion of the fracture site. Rarely it occurs as a complication of acute osteomyelit is now-a-days. The pattern and behaviour of organisms are constantly changing under the pressure of newer antibiotics .As a result the wonder drugs of fifties have been relegated to a position of limited usefulness today. With this background, it is felt worthwhile to study the spectrum of organisms Causing osteomyelitis and their antimicrobial susceptibility pattern. AIM OF THE STUDY : To study the predisposing factors associated with chronic Osteomyelitis. To study the causative organisms and their antimicrobial susceptibility pattern. To study the resistance pattern in common isolates. MATERIALS AND METHODS : The necessary ethical committee approval was obtained before the commencement of the study. Informed consent was obtained from the study population. All patients satisfying the inclusion criteria were documented. Patients were interviewed by structured questionnaire. Inclusion Criteria : Patients older than 12 years. Patients admitted in orthopaedic wards and those attending outpatient department who satisfy one of the following six components of chronic osteomyelitis. Osteomyelitis in association with trauma only. Osteomyelitis in association with diabetes and peripheral vascular compromise. Clinical evidence of chronic disease. (Eg. Mycobacterium tuberculosis). Radiological changes suggestive of infection for 6 weeks or more. Formation of sequestrum or sclerosis. Even after treatment, persistence or relapse of infection. Exclusion Criteria : Patients with prosthetic orthopaedic implants devices. Paediatric age group (