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[多发伤后骨科手术手术部位感染的病因]

[Etiology of surgical site infections in orthopedic surgery after multiple injuries].

作者信息

Barański Mariusz, Kwiatkowski Krzysztof, Chwedczuk Bartosz, Sadowski Jarosław

出版信息

Pol Merkur Lekarski. 2014 Aug;37(218):82-5.

Abstract

UNLABELLED

Surgical site infection is one of the most severe complications in patients with multiple injuries. It causes elongation of hospitalization time, greatly increases costs of treatment and may directly endanger patient's life. The aim of the study was to analyze bacterial flora causing surgical site infections in group of patients with multiple injuries.

MATERIAL AND METHODS

A retrospective analysis was conducted on medical history of 31 patients with multiple injuries, who in years 2011-2012 due to surgical site infections required further treatment in Department of Musculoskeletal System Infections.

RESULTS

In analyzed material majority of infections were caused by multiple bacteria species--18 (58%). Throughout the isolated flora the most frequent were gram-negative bacteria, especially A. baumanii--16 (29.6%) and P. areuginosa--5 (9.3%). Participation of gram-positive flora which until now was dominating as a cause of musculoskeletal system infections, has significantly decreased. Additionally, in this group we can see dominance of bacteria from Enterococcus genus--E. fecalis--10 (18.5%), and not as it used to be from Staphylococcus--S. aureus--6 (11%), S. epidermidis--3 (5.6%).

CONCLUSIONS

The most common were acute infections caused by multiple bacteria species with dominance of gram-negative flora. Very interesting is the fact of fall of infection rate caused by Staphylococci. Monitoring of bacterial etiological factors has a key role in proper antibiotic administration, with is essential in successful surgical treatment.

摘要

未标注

手术部位感染是多发伤患者最严重的并发症之一。它会延长住院时间,大幅增加治疗费用,并可能直接危及患者生命。本研究的目的是分析多发伤患者手术部位感染的细菌菌群。

材料与方法

对31例多发伤患者的病史进行回顾性分析,这些患者在2011 - 2012年因手术部位感染需要在肌肉骨骼系统感染科接受进一步治疗。

结果

在分析的资料中,大多数感染是由多种细菌引起的——18例(58%)。在分离出的菌群中,最常见的是革兰氏阴性菌,尤其是鲍曼不动杆菌——16例(29.6%)和铜绿假单胞菌——5例(9.3%)。迄今为止作为肌肉骨骼系统感染主要病因的革兰氏阳性菌的比例已显著下降。此外,在这组患者中我们可以看到肠球菌属细菌占主导——粪肠球菌——10例(18.5%),而不是像过去那样由葡萄球菌属主导——金黄色葡萄球菌——6例(11%),表皮葡萄球菌——3例(5.6%)。

结论

最常见的是由多种细菌引起的急性感染,革兰氏阴性菌占主导。葡萄球菌引起的感染率下降这一事实非常有趣。监测细菌病因学因素在合理使用抗生素方面起着关键作用,这在成功的手术治疗中至关重要。

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