[Open leg fracture with Bacillus cereus infection]

Abstract

Objective: To investigate leg fractures infected with Bacillus cereus in a traumatology-orthopedic ward of a university hospital.

Methods: All B. cereus strains isolated from patients with leg fracture hospitalized in the traumatology-orthopedic ward between 1995 and 2004 were included in this retrospective study.

Results: Five hundred and four patients had leg fracture during this period. Thirty-four patients were included in this retrospective study. B. cereus strains clinical isolates were mainly isolated from patients who had initially leg fractures with telluric contamination (wound contamination with terrestrial environments) before admission. Betalactam antibiotics used for prophylactic chemotherapy were not effective against B. cereus.

Conclusion: In this study, we underscore the significance of Sfar recommendations concerning prophylactic chemotherapy. However, B. cereus could be termed an emerging pathogen and physicians need to be aware of its potential importance in trauma cases. In this purpose, a systematic screening for B. cereus at admission should be necessary in front of patients with open fractures associated with telluric contamination. Furthermore, if B. cereus is isolated, chemotherapy should be based upon ciprofloxacin during 2 or 6 weeks.