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海水污染开放性骨折的描述性研究:感染、病原体与抗生素耐药性

A Descriptive Study of Open Fractures Contaminated by Seawater: Infection, Pathogens, and Antibiotic Resistance.

作者信息

Zhu Hongyi, Li Xingwei, Zheng Xianyou

机构信息

Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

出版信息

Biomed Res Int. 2017;2017:2796054. doi: 10.1155/2017/2796054. Epub 2017 Feb 20.

Abstract

. In this work, the main objectives were to investigate the clinical characteristics and bacterial spectrum present in open fractures contaminated by seawater. . We conducted a retrospective cohort study and included all patients with open fractures from 1st January, 2012, to 31st December, 2015, in our hospital. Patients were grouped based on the presence of seawater contamination in wounds. We compared the infection rate, bacterial spectrum, and antibiotic resistance between the two groups. . We totally included 1337 cases of open fracture. Wounds from 107 cases (8.0%) were contaminated by seawater. The wound infection rate of seawater-contaminated group was significantly higher in patients with Gustilo-Anderson Type II and Type III open fractures. The bacterial spectrum from seawater-contaminated wounds was remarkably different from that of the remaining. Antibiotic sensitivity tests revealed that more than 90% of infecting pathogens in seawater-contaminated wounds were sensitive to levofloxacin and ciprofloxacin. . Cephalosporin in combination with quinolone was recommended in the early-stage management of open fractures contaminated by seawater.

摘要

在本研究中,主要目的是调查海水污染开放性骨折的临床特征和细菌谱。我们进行了一项回顾性队列研究,纳入了我院2012年1月1日至2015年12月31日期间所有开放性骨折患者。根据伤口是否存在海水污染对患者进行分组。我们比较了两组之间的感染率、细菌谱和抗生素耐药性。我们共纳入1337例开放性骨折病例。107例(8.0%)伤口被海水污染。在Gustilo-Anderson II型和III型开放性骨折患者中,海水污染组的伤口感染率显著更高。海水污染伤口的细菌谱与其余伤口明显不同。抗生素敏感性试验显示,海水污染伤口中超过90%的感染病原体对左氧氟沙星和环丙沙星敏感。对于海水污染的开放性骨折,建议在早期治疗中联合使用头孢菌素和喹诺酮类药物。

相似文献

本文引用的文献

7
Antibiotic resistance-the need for global solutions.抗生素耐药性——全球解决方案的必要性。
Lancet Infect Dis. 2013 Dec;13(12):1057-98. doi: 10.1016/S1473-3099(13)70318-9. Epub 2013 Nov 17.
8
In brief: Gustilo-Anderson classification. [corrected].简而言之: Gustilo-Anderson 分类法。[已修正]
Clin Orthop Relat Res. 2012 Nov;470(11):3270-4. doi: 10.1007/s11999-012-2376-6. Epub 2012 May 9.

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