Alp Emine, Cevahir Fatma, Ersoy Safiye, Guney Ahmet
Erciyes University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Kayseri, Turkey; Erciyes University, Faculty of Medicine, Erciyes University, Faculty of Medicine, Infection Control Committee, Kayseri, Turkey.
Erciyes University, Faculty of Medicine, Erciyes University, Faculty of Medicine, Infection Control Committee, Kayseri, Turkey.
J Infect Public Health. 2016 Jul-Aug;9(4):494-8. doi: 10.1016/j.jiph.2015.12.014. Epub 2016 Jan 29.
In this study, we aimed to evaluate the incidence and economic burden of prosthetic joint infections (PJIs) in a university hospital in a middle-income country. Surveillance data between April 2011 and April 2013 in the Orthopedic Surgery Department was evaluated. Patients (>16 years old) who had primary arthroplasty in Erciyes University were included in the study, and patients with preoperative infection were excluded. Patients were followed up during their stay in the hospital and during readmission to the hospital for PJI by a trained Infection Control Nurse. During the study period, 670 patients were followed up. There were 420 patients (62.7%) with total hip arthroplasty (THA), 241 (36.0%) with total knee arthroplasty (TKA) and 9 (1.3%) with shoulder arthroplasty (SA). The median age was 64, and 70.6% were female. The incidence of PJI was 1.2% (5/420) in THA, 4.6% (11/241) in TKA and 0% (0/9) in SA. PJI was significantly more prevalent in TKA (p=0.029). All of the PJIs showed early infection, and the median time for the development of PJI was 23.5 days (range 7-120 days). The median total length of the hospital stay was seven times higher in PJI patients than patients without PJI (49 vs. 7 days, p=0.001, retrospectively). All hospital costs were 2- to 24-fold higher in patients with PJI than in those without PJI (p=0.001). In conclusion, the incidence and economic burden of PJI was high. Implementing a national surveillance system and infection control protocols in hospitals is essential for the prevention of PJI and a cost-effective solution for the healthcare system in low-middle-income countries.
在本研究中，我们旨在评估一个中等收入国家的一家大学医院中人工关节感染（PJI）的发生率和经济负担。对2011年4月至2013年4月期间骨科手术科室的监测数据进行了评估。纳入了在埃尔西耶斯大学接受初次关节置换术的患者（年龄>16岁），并排除术前感染患者。由一名经过培训的感染控制护士在患者住院期间以及因PJI再次入院期间对其进行随访。在研究期间，对670例患者进行了随访。其中有420例（62.7%）接受了全髋关节置换术（THA），241例（36.0%）接受了全膝关节置换术（TKA），9例（1.3%）接受了肩关节置换术（SA）。中位年龄为64岁，女性占70.6%。THA中PJI的发生率为1.2%（5/420），TKA中为4.6%（11/241），SA中为0%（0/9）。PJI在TKA中明显更为常见（p=0.029）。所有PJI均表现为早期感染，PJI发生的中位时间为23.5天（范围7 - 120天）。回顾性分析显示，PJI患者的中位住院总时长比无PJI患者高7倍（49天对7天，p=0.001）。所有住院费用方面，有PJI的患者比无PJI的患者高2至24倍（p=0.001）。总之，PJI的发生率和经济负担都很高。在医院实施国家监测系统和感染控制方案对于预防PJI以及为中低收入国家的医疗保健系统提供具有成本效益的解决方案至关重要。
