Version 1: Bacterial profile of wound site infections and evaluation of risk factors for sepsis among road traffic accident (RTA) patients from Apex trauma centre, Northern India

Background: There is limited data about the bacterial contamination of Road traffic accident (RTA) wounds and their antibiotic susceptibility patterns.

Materials and Methods: This prospective study was conducted in a tertiary care centre in Northern India from January 2023 to January 2024. Wound deep swabs and aspirates were collected from RTA patients presenting to Apex Trauma centre. Gram stain and culture were performed and the isolates were subjected to antibiotic susceptibility testing. Organism identification was done using MALDI-TOF MS. Blood samples were also collected to rule out blood stream infections during follow up if patient became febrile or shown symptoms of systemic infection. 

Results: A total of 189 wound samples were collected in which 97 (51.32%) samples showed the growth of microorganisms. The isolates included 69 (71.13%) Gram-negative bacilli in which majority were Klebsiella pneumoniae and 28 (28.86%) Gram-positive cocci in which majority were Staphylococcus aureus. 22 (11.64%) patients died during the hospital course. Sepsis developed in 50 (26.45%) patients in which Gram-negative bacilli were the predominant microorganism. Risk factors evaluated as significant for sepsis were raised procalcitonin level, low Glasgow coma scale score (GCS), higher injury severity score (ISS), need for mechanical ventilation, raised qSOFA (quick sequential organ failure assessment) score. Among the Gram negative isolates, 100% susceptibility was seen for colistin. Among the Staphylococcus aureus, 100% susceptibility was seen for vancomycin, teicoplanin and levonadifloxacin.

Conclusion: It is essential to ascertain the profile of microorganism isolated from RTA wounds in order to reduce antimicrobial resistance and to deliver efficient treatment.