Mahan J, Seligson D, Henry S L, Hynes P, Dobbins J
Department of Orthopedic Surgery, University of Louisville, KY 40292.
Orthopedics. 1991 Mar;14(3):305-8.
To determine the factors pertinent to the etiology of pin tract infections, 214 pins in 42 patients were examined prospectively at the time of pin removal. Eighty-nine (41.6%) pin tracts were inflamed, 49 (22.9%) pins had loose anchorages, and 160 (74.8%) pin tips cultured positive for bacteria. The predominant organism cultured was Staphylococcus epidermidis (90.6%), considered nonvirulent, followed by virulent Staphylococcus aureus (37.5%), and Escherichia coli (9.4%). There were 32 loose, inflamed pin tracts. This correlation was statistically significant (P less than .005). There were 40 loose pins whose pin tips had positive cultures. Loose pins correlated for infection with virulent species of bacteria at a highly significant level (P less than .005). Results demonstrate that most pins possess bacterial colonization. Clinically, this means that either inflamed pin tracts or pins with cultures positive for invasive organisms are probably loose and should be removed. Also, mechanical factors are the critical variable in determining the flora of external fixation pins.
为确定与针道感染病因相关的因素，对42例患者的214根针在拔针时进行了前瞻性检查。89个（41.6%）针道有炎症，49根（22.9%）针固定不牢，160个（74.8%）针尖端细菌培养呈阳性。培养出的主要微生物是表皮葡萄球菌（90.6%），被认为无毒力，其次是有毒力的金黄色葡萄球菌（37.5%）和大肠杆菌（9.4%）。有32个针道松动且有炎症。这种相关性具有统计学意义（P小于0.005）。有40根松动的针其尖端培养呈阳性。松动的针与有毒力的细菌种类感染高度相关（P小于0.005）。结果表明大多数针存在细菌定植。临床上，这意味着要么针道有炎症，要么针对于侵袭性微生物培养呈阳性，可能是松动的，应该拔除。此外，机械因素是决定外固定针菌群的关键变量。
