Liu Shaoqiang, Qi Qiang, Chen Zhongqiang, Liu Ning, Guo Zhaoqing, Sun Chuiguo, Li Weishi, Zeng Yan, Liu Zhongjun
Department of Orthopedics, Peking University Third Hospital, Beijing, China.
Department of Spine Surgery, Fuzhou Second Hospital of Xiamen University, Fuzhou, China.
Asian Spine J. 2017 Jun;11(3):427-436. doi: 10.4184/asj.2017.11.3.427. Epub 2017 Jun 15.
A retrospective clinical review.
To investigate the difference in clinical manifestations and severity between polymicrobial and monomicrobial infections after spinal surgery.
Surgical site infections (SSIs) after spinal surgery are a major diagnostic and therapeutic challenge for spinal surgeons. Polymicrobial infections after spinal surgery seem to result in poorer outcomes than monomicrobial infections because of complementary resistance to antibiotics. However, comparison of the clinical manifestations and severity between polymicrobial and monomicrobial infections are limited.
Sixty-seven patients with SSIs after spinal surgery were studied: 20 patients with polymicrobial infections and 47 with monomicrobial infections. Pathogenic bacteria identified were counted and classified. Age, sex, and body mass index were compared between the two groups to identify homogeneity. The groups were compared for clinical manifestations by surgical site, postoperative time to infection, infection site, incisional drainage, incisional swelling, incisional pain, neurological signs, temperature, white blood cell count, and the percentage of neutrophils. Finally, the groups were compared for severity by hospital stay, number of rehospitalizations, number of debridements, duration of antibiotics administration, number of antibiotics administered, and implant removal.
Polymicrobial infections comprised 29.9% of SSIs after spinal surgery, and most polymicrobial infections (70.0%) were caused by two species of bacteria only. There was no difference between the groups in terms of clinical manifestations and severity. In total, 96 bacterial strains were isolated from the spinal wounds: 60 strains were gram-positive and 36 were gram-negative pathogenic bacteria. , , , and were cultured in order of the frequency of appearance.
Most polymicrobial infections were caused by two bacterial species after spinal surgery. There was no difference in clinical manifestations or severity between polymicrobial and monomicrobial infections.
一项回顾性临床研究。
探讨脊柱手术后多微生物感染与单微生物感染在临床表现及严重程度上的差异。
脊柱手术后手术部位感染（SSIs）是脊柱外科医生面临的主要诊断和治疗挑战。脊柱手术后的多微生物感染似乎比单微生物感染导致更差的预后，因为对多种抗生素具有互补性耐药。然而，多微生物感染与单微生物感染在临床表现和严重程度方面的比较有限。
对67例脊柱手术后发生SSIs的患者进行研究：20例为多微生物感染患者，47例为单微生物感染患者。对鉴定出的病原菌进行计数和分类。比较两组患者的年龄、性别和体重指数以确定同质性。比较两组患者在手术部位、术后感染时间、感染部位、切口引流、切口肿胀、切口疼痛、神经体征、体温、白细胞计数及中性粒细胞百分比等方面的临床表现。最后，比较两组患者在住院时间、再次住院次数、清创次数、抗生素使用时间、使用抗生素种类及植入物取出情况等方面的严重程度。
多微生物感染占脊柱手术后SSIs的29.9%，且大多数多微生物感染（70.0%）仅由两种细菌引起。两组在临床表现和严重程度方面无差异。总共从脊柱伤口分离出96株细菌菌株：60株为革兰氏阳性菌，36株为革兰氏阴性病原菌。 、 、 及 按出现频率依次培养。
脊柱手术后大多数多微生物感染由两种细菌引起。多微生物感染与单微生物感染在临床表现或严重程度上无差异。
