Guo Geyong, Wang Jiaxing, You Yanan, Tan Jiaqi, Shen Hao
Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China.
Department of Obstetrics, Fudan University Affiliated Obstetrics and Gynecology Hospital, Shanghai 200233, P.R. China.
Exp Ther Med. 2017 Jun;13(6):2599-2608. doi: 10.3892/etm.2017.4300. Epub 2017 Apr 4.
Periprosthetic joint infection (PJI) is a devastating condition and spp. are the predominant pathogens responsible, particularly coagulase-negative staphylococci (CoNS) and . The aim of the present systematic review was to evaluate the distribution characteristics of specific spp. in different PJI phases, reveal the effect of pathogens' feature on their distribution and suggest recommendations for antibiotic treatment of Staphylococcal PJI. The present systematic review was performed using PubMed and EMBASE databases with the aim to identify existing literature that presented the spectrum of spp. that occur in PJI. Once inclusion and exclusion criteria were applied, 20 cohort studies involving 3,344 cases in 3,199 patients were included. The predominant pathogen involved in PJI was indicated to be CoNS (31.2%), followed by (28.8%). This trend was more apparent in hip replacement procedures. In addition, almost equal proportions of CoNS and (28.6 and 30.0%, respectively) were indicated in the delayed phase. CoNS (36.6%) were the predominant identified organism in the early phase, whereas (38.3%) occurred primarily in the late phase. In PJI caused by , the number of cases of methicillin-sensitive (MSSA) was ~2.5-fold greater than that of methicillin-resistant (MRSA). MRSA occurred predominantly in the early phase, whereas MSSA was largely observed in the delayed and late phases. With regards to antibiotic treatment, the feature of various pathogens and the phases of PJI were the primary considerations. The present review provides useful information for clinical practice and scientific research of PJI.
人工关节周围感染（PJI）是一种严重的病症，[病原体名称]是主要的致病原，尤其是凝固酶阴性葡萄球菌（CoNS）和[另一种病原体名称]。本系统评价的目的是评估特定[病原体名称]在不同PJI阶段的分布特征，揭示病原体特征对其分布的影响，并提出针对葡萄球菌性PJI的抗生素治疗建议。本系统评价使用PubMed和EMBASE数据库进行，旨在识别呈现PJI中出现的[病原体名称]谱的现有文献。应用纳入和排除标准后，纳入了20项队列研究，涉及3199例患者中的3344例病例。PJI中涉及的主要病原体为CoNS（31.2%），其次是[另一种病原体名称]（28.8%）。这种趋势在髋关节置换手术中更为明显。此外，在延迟期，CoNS和[另一种病原体名称]的比例几乎相等（分别为28.6%和30.0%）。CoNS（36.6%）是早期主要鉴定出的微生物，而[另一种病原体名称]（38.3%）主要出现在晚期。在由[另一种病原体名称]引起的PJI中，甲氧西林敏感[另一种病原体名称]（MSSA）的病例数比耐甲氧西林[另一种病原体名称]（MRSA）的病例数多约2.5倍。MRSA主要发生在早期，而MSSA主要在延迟期和晚期观察到。关于抗生素治疗，各种病原体的特征和PJI的阶段是主要考虑因素。本综述为PJI的临床实践和科学研究提供了有用信息。
