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[墨西哥城一家专科医院髋膝关节假体感染的发生率]

[Incidence of hip and knee prosthetic infections in a specialized center of Mexico City].

作者信息

Franco-Cendejas Rafael, Contreras-Córdova Erika Lizbeth, Mondragón-Eguiluz Jaime Arturo, Vanegas-Rodríguez Edgar Samuel, Ilizaliturri-Sánchez Víctor Manuel, Galindo-Fraga Arturo

机构信息

Laboratorio de Infectología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.

Laboratorio de Infectología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México.

出版信息

Cir Cir. 2017 Nov-Dec;85(6):485-492. doi: 10.1016/j.circir.2016.10.032. Epub 2016 Dec 18.

Abstract

BACKGROUND

Hip and knee prosthetic replacements have proven to be the most appropriate treatment in the joints that do not benefit from medical or arthroscopic interventions; however, infections are the most feared complication. It is recommended that the incidence of infection should not exceed 2%.

MATERIAL AND METHODS

This was an observational, prospective, longitudinal and observational study conducted in patients fitted with a prosthetic joint from August 2011 to July 2012. Patients were followed up pre and post-surgery for one year to identify a prosthetic infection, diagnosed using international parameters. We calculated the incidence of prosthetic infection, as well as the incidence density.

RESULTS

A total of 339 patients (179 hip and 160 knee) were included. Variations in the time of pre-operative antibiotics' administration were observed. Six prosthetic infections were identified with an incidence rate of 1.79/339 arthroplasties, 2.2/179 hip procedures, and 1.25/160 knee arthroplasties. An incidence density of 0.02/year for hip arthroplasties and 0.11/year for knee procedures was identified. There were 4 infections of hip and 2 of knee. Five infections were acute and one chronic. The isolated microorganisms were E. faecalis, S. epidermidis (2), S. mitis, S. aureus and P. stomatis.

CONCLUSIONS

The incidence of prosthetic joint infection in the first year of follow-up at our centre is within the recommended parameters. Surgical techniques and organizational practices influence the results.

摘要

背景

髋关节和膝关节置换术已被证明是对那些无法从药物或关节镜干预中获益的关节最适宜的治疗方法;然而,感染是最令人担忧的并发症。建议感染发生率不应超过2%。

材料与方法

这是一项于2011年8月至2012年7月对安装了人工关节的患者进行的观察性、前瞻性、纵向研究。对患者在手术前后进行为期一年的随访,以确定人工关节感染情况,采用国际参数进行诊断。我们计算了人工关节感染的发生率以及发病密度。

结果

共纳入339例患者(179例髋关节置换和160例膝关节置换)。观察到术前抗生素使用时间存在差异。确定了6例人工关节感染,发生率为1.79/339例关节成形术,髋关节手术为2.2/179例,膝关节置换术为1.25/160例。确定髋关节置换术的发病密度为0.02/年,膝关节手术为0.11/年。有4例髋关节感染和2例膝关节感染。5例感染为急性,1例为慢性。分离出的微生物有粪肠球菌、表皮葡萄球菌(2例)、缓症链球菌、金黄色葡萄球菌和口腔类杆菌。

结论

我们中心随访第一年人工关节感染的发生率在推荐参数范围内。手术技术和组织操作会影响结果。

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