Bacterial profile, treatment outcomes and its determinants among adult patients with musculoskeletal infections admitted to Jimma medical center: A prospective observational study.

Abstract

Background: Epidemiological features of musculoskeletal infections are in continuous evolution. Up to 50% of musculoskeletal infections show negative cultures. Despite the high burden of musculoskeletal infections in sub-Saharan Africa, data are scarce regarding musculoskeletal infections about possible etiologies and treatment outcomes in the region. Objective: to assess bacterial profile, treatment outcomes and its determinants among adult patients with musculoskeletal infections admitted to Jimma medical center, southwest Ethiopia. Methods: An institution-based prospective observational study was conducted on patients with musculoskeletal infections admitted to Jimma medical center from July 2022-December 2022. A semi-structured questionnaire was used to collect data. Data entry was done by Epi data version 4.6 and Statistical Package for Social Science version 27 was used for data analysis. Bivariate logistic regression was done to see associations between the dependent and independent variables. To identify the independent determinants of outcome, multivariate logistic regression analysis was conducted. Variables with p-value <0.05 were considered as statistically significant. Result: Of the total of 160 participants included in the study, 103(64.37%) were male, and the mean ± SD age of patients was 33.51±13.56 years. Microbial growth was seen in 94(58.8%) of patients, from this 75.5% accounts for monomicrobial. Treatment failure was observed in 75 (46.9%) of the patients. Staphylococcus aureus was predominantly observed on 26(22.4%) of the tests. The majority of etiologies were resistant to ceftriaxone (81.70%). Sex [AOR = 2.56, 95%CI (1.07-6.23), P=0.034], microbial growth [AOR = 3.03, 95%CI (1.31-6.97), P=0.009], ceftriaxone resistance [AOR = 4.46, 95%CI (1.06-18.67), P=0.040], co-morbidities [AOR = 2.32, 95%CI (1.007-5.36), P=0.048], and complications [AOR = 2.80, 95%CI (1.26-6.20), P=0.011] were associated with treatment failure outcome. Switching parenteral antibiotics to PO and Patients who underwent surgical procedures were less likely to experience treatment failure. Conclusion: Staphylococcus aureus was the most commonly identified etiology in patients with musculoskeletal infections. Treatment failure was observed in nearly half of patients. Sex, microbial growth, Ceftriaxone resistance, co-morbidities, and in-hospital complications, were associated with treatment failure. But, switching of parenteral antibiotics to oral and surgical intervention were determinants of recovered outcomes. For recovered outcome, proper antibiotic selection and considering switching of parenteral antibiotics to oral therapy are recommended.