Rafiq Imran, Gambhir A K, Wroblewski B M, Kay P R
Centre for Hip Surgery, Wrightington Hospital, Wigan, England, UK.
Int Orthop. 2006 Dec;30(6):532-5. doi: 10.1007/s00264-006-0125-8. Epub 2006 Aug 1.
Infection following joint replacement surgery although rare presents a challenging problem. Bacterial resistance to antibiotics is an emerging problem. We analysed the microbiology of 337 single-stage revisions for deep infection. Coagulase negative staphylococcus was found to be the predominant organism, although staphylococcus aureus is gaining importance. Gentamicin only provides cover for 64.1% of organisms. Resistance to this commonly used antibiotic prophylaxis is escalating. Fusidic acid and erythromycin provide improved cover. We would suggest on a microbiological basis that these antibiotics be considered for addition to acrylic bone cement. This will provide local antibiotic delivery when performing a revision for deep infection.
关节置换术后感染虽然罕见，但却是一个具有挑战性的问题。细菌对抗生素的耐药性是一个新出现的问题。我们分析了337例因深部感染进行的单阶段翻修手术的微生物情况。虽然金黄色葡萄球菌的重要性日益增加，但凝固酶阴性葡萄球菌仍是主要病原体。庆大霉素仅能覆盖64.1%的病原体。对这种常用抗生素预防措施的耐药性正在上升。夫西地酸和红霉素能提供更好的覆盖。我们建议基于微生物学考虑，将这些抗生素添加到丙烯酸骨水泥中。这将在进行深部感染翻修手术时实现局部抗生素递送。
