To characterize the causative agents of bone and joint infections (BJIs) and their resistance patterns in a tropical setting, specifically in Guadeloupe, to inform empirical antibiotic treatment.
Key Findings:
41% of isolates were Gram-negative bacilli (GNB), with significant prevalence of AmpC β-lactamase–producing Enterobacterales (13%) and Pseudomonas aeruginosa (9%).
GNB were identified in 31% of native septic arthritis, 33% of spondylodiscitis, 38% of prosthetic joint infections, 47% of osteosynthesis-associated infections, and 52% of osteomyelitis.
Cefazolin showed limited in vitro adequacy against pathogens in native septic arthritis (74%), compared to cefepime (92%) and piperacillin-tazobactam (92%).
Interpretation:
The study highlights the high prevalence of GNB in tropical BJIs, indicating a need for tailored empirical antibiotic strategies that consider local resistance patterns.
Limitations:
The study is limited to a single tertiary care center, which may not represent broader epidemiological trends.
Retrospective design may introduce biases in data collection and analysis, potentially affecting the reliability of the findings.
Conclusion:
The findings emphasize the need for local surveillance systems to guide empirical treatment strategies for BJIs in tropical regions, particularly in light of antibiotic resistance.
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