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: Among the most significant yet often ignored health issues worldwide are trauma and accidents. India accounts for 11% of global deaths in road accidents, highest in the world according to the World Bank report. There is limited data about the bacterial contamination of road traffic accident (RTA) wounds and their antibiotic susceptibility pattern. 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 or aspirates were collected from RTA patients with traumatic injuries at different time interval. Gram stain and culture was performed and positive aerobic culture was subjected to antibiotic susceptibility testing. Organism identification was done using MALDI-TOF MS and routine biochemical test. Blood samples were also collected to rule out blood stream infections during follow up if patient became febrile or shown symptoms of systemic infection. Sepsis was defined in those patients who had two or more score in SIRS criteria with positive microbiological culture. Risk factors were evaluated for sepsis on the basis of patient’s vitals, injury characteristics, procalcitonin, glasgow coma scale score, need for mechanical ventilation and complete blood count which was obtained from the patient’s admission file. Results: A total of 189 wound samples were collected in which 99 (52.38%) samples showed the growth of microorganisms. The aerobic isolates included 69 (69.69%) gram-negative bacilli in which majority were Klebsiella pneumoniae, 28 (28.28%) gram-positive cocci in which majority were Staphylococcus aureus and 02 (2.02%) anaerobic isolates. Among the gram-negative isolates, none of the isolates were resistant to colistin. All Staphylococcus aureus isolates were susceptible to vancomycin, teicoplanin and levonadifloxacin. Sepsis developed in 50 (26.45%) patients. 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. Conclusion: It is essential to ascertain the profile of microorganism isolated from RTA wounds in order to reduce antibiotic resistance and to deliver efficient treatment.