Department of Infectious Diseases, St Vincent's Hospital, Melbourne, Victoria, Australia.
J Hosp Infect. 2011 Oct;79(2):129-33. doi: 10.1016/j.jhin.2011.06.001. Epub 2011 Aug 6.
Prosthetic joint infection is a devastating complication of arthroplasty. Previous epidemiological studies have assessed factors associated with arthroplasty infections but have not assessed the impact of comorbidity on infection at different arthroplasty locations. We used a case-control design to investigate risk factors for prosthetic joint infection with reference to the anatomical site. During an eight-year period at a single hospital, 63 patients developed a prosthetic joint infection (36 hips, 27 knees). Cases of prosthetic hip or knee joint infection were matched 1:2 to controls. The results suggest that factors associated with arthroplasty infections differ with anatomical location. Following knee arthroplasty, wound discharge was associated with an increased risk of prosthetic joint infection whereas the presence of a drain tube reduced the risk. By contrast, increased body mass index, increased drain tube loss and superficial incisional surgical site infections (SSIs) were associated with prosthetic hip infection. When analysed as a combined cohort, systemic steroid use, increased SSI drain tube losses, wound discharge, and superficial incisional SSIs were predictors of infection.
人工关节感染是关节置换术的一种毁灭性并发症。以前的流行病学研究评估了与关节置换感染相关的因素，但没有评估合并症对不同关节置换部位感染的影响。我们使用病例对照设计，针对解剖部位调查人工关节感染的危险因素。在一家医院的八年期间，63 名患者发生了人工关节感染（36 髋，27 膝）。人工髋关节或膝关节感染的病例与对照组 1:2 匹配。结果表明，与解剖部位相关的关节置换感染的因素不同。膝关节置换后，伤口分泌物与人工关节感染的风险增加有关，而引流管的存在则降低了风险。相比之下，体重指数增加、引流管丢失增加和浅表切口手术部位感染（SSI）与人工髋关节感染有关。当作为一个综合队列进行分析时，全身类固醇使用、增加的 SSI 引流管丢失、伤口分泌物和浅表切口 SSI 是感染的预测因素。
