A Case Report: Surgical Site Infection of Open Fracture Grade IIIC Caused by Methicillin-Resistant Staphylococcus aureus (MRSA)

Abstract

Introduction: Based on World Health Organization (WHO) data in 2016, Surgical Site Infections (SSIs) occur in 11% of patients undergoing the procedure operations in developing countries. Overall, Staphylococcus aureus\xa0was the commonest bacteria isolated of the cultures in the postoperative period. Now, its considered endemic to most hospitals as Hospital Associated MRSA.\xa0Case History and Examination: A 60-year-old male presented to Rumah Sakit Daerah (RSD) dr. Soebandi Jember with a severe open fracture of his right lower extremity (cruris dextra) after hit by a truck. Patient came with massive bleeding because the rupture of tibial and femoral arteries. He had already given initial prophylactic antibiotic treatment such as cefazolin and amoxicillin before the operative procedure. After more than 3 months, he suffered a pyogenic infection with a biofilm plaque formation on his surgical sites.\xa0\xa0Microbiology Examination and Diagnosis: This Staphylococcus aureus\xa0resisted to 12 of 18 antibiotics that was tested including beta-lactams and macrolides groups of antibiotics. Treatment and Course: This case has already reported to the hospital and the patient was given topical Gentamicin and oral Clindamycin.\xa0Discussion: The initial mistreatment of fracture really becomes the risk factor of surgical site infection, and also this patient’s condition included significant risk factors for SSI because of his age, location of injury cleanliness, and high-energy injury. Conclusion and Recommendations: This case report of SSI in a postoperative of severe open fracture can be used to evaluate the empirical treatment that is used in RSD dr. Soebandi Jember.