Norton Thomas D, Skeete Faith, Dubrovskaya Yanina, Phillips Michael S, Bosco Joseph D, Mehta Sapna A
Department of Orthopaedic Surgery, New York University School of Medicine, New York, NY.
Am J Orthop (Belle Mead NJ). 2014 May;43(5):E89-92.
Data that can be used to guide perioperative antibiotic prophylaxis in our era of emerging antibiotic resistance are limited. We reviewed orthopedic surgeries complicated by surgical site infections (SSIs). Eighty percent of 69 arthroplasty and 80 spine fusion SSIs were infected with Gram-positive bacteria; most were staphylococcal species; and more than 25% of Staphylococcus aureus and more than 65% of coagulase-negative staphylococci were methicillin-resistant. Gram-negative bacteria were isolated from 30% of arthroplasty SSIs and 25% of spine fusion SSIs. Resistance to cefazolin was higher than 40%. A significant proportion of SSIs were caused by resistant organisms, and antibiotic guidelines were altered to provide more adequate surgical prophylaxis.
在我们这个抗生素耐药性不断出现的时代，可用于指导围手术期抗生素预防的数据有限。我们回顾了并发手术部位感染（SSI）的骨科手术。69例关节成形术和80例脊柱融合术的手术部位感染中有80%感染革兰氏阳性菌；大多数是葡萄球菌属；超过25%的金黄色葡萄球菌和超过65%的凝固酶阴性葡萄球菌对甲氧西林耐药。30%的关节成形术手术部位感染和25%的脊柱融合术手术部位感染分离出革兰氏阴性菌。对头孢唑林的耐药率高于40%。相当一部分手术部位感染是由耐药菌引起的，因此对抗生素指南进行了修改，以提供更充分的手术预防措施。
