R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.
Department of Orthopaedics, Indiana University Health Methodist Hospital, Indianapolis, IN.
J Orthop Trauma. 2018 Dec;32(12):e475-e481. doi: 10.1097/BOT.0000000000001305.
To quantify the current bacteriology of deep surgical site infections (SSIs) after fracture surgery at 1 institution and to compare those data with historical controls at the same institution, assessing variations in infecting organisms over the past decade.
Retrospective review.
Level I trauma center.
PATIENTS/PARTICIPANTS: Two hundred forty-three patients requiring surgical intervention for deep SSI between January 2011 and December 2015 were compared with 211 patients requiring surgical intervention for deep SSI between December 2006 and December 2010.
None.
Bacteria were categorized as Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus, Enterococcus, gram-negative rods (GNR), gram-positive rods, anaerobes, or negative cultures. The proportion of each bacterial type was determined and compared with previously published data from the same trauma center (December 2006 to December 2010).
Patients most commonly had S. aureus infections (48%), followed by GNR (40%) and CoNS (19%). The proportion of CoNS species (26% vs. 12%, P < 0.01) in infected patients was significantly higher during the current study period compared with historical controls. The proportion of S. aureus species in infected patients was significantly less during the current study period (39% vs. 56%, P < 0.01). The reduction in the proportion of S. aureus species in infected patients was driven by a decrease in the proportion of methicillin-resistant S. aureus (MRSA) in the overall sample.
Bacteriology of deep SSI of fractures has changed substantially over the past decade at our center, specifically the proportions of GNR, CoNS, and MRSA.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
量化 1 家机构骨折手术后深部手术部位感染（SSI）的当前细菌学情况，并将这些数据与同一机构的历史对照数据进行比较，评估过去 10 年中感染病原体的变化。
回顾性研究。
1 级创伤中心。
患者/参与者：将 2011 年 1 月至 2015 年 12 月期间因深部 SSI 需手术干预的 243 例患者与 2006 年 12 月至 2010 年 12 月期间因深部 SSI 需手术干预的 211 例患者进行比较。
无。
细菌分为金黄色葡萄球菌、凝固酶阴性葡萄球菌（CoNS）、链球菌、肠球菌、革兰阴性杆菌（GNR）、革兰阳性杆菌、厌氧菌或阴性培养物。确定每种细菌类型的比例，并与同一创伤中心之前发表的数据（2006 年 12 月至 2010 年 12 月）进行比较。
患者最常见的感染是金黄色葡萄球菌（48%），其次是 GNR（40%）和 CoNS（19%）。在当前研究期间，感染患者中 CoNS 种类（26%比 12%，P<0.01）的比例明显高于历史对照。在当前研究期间，感染患者中金黄色葡萄球菌种类的比例明显降低（39%比 56%，P<0.01）。感染患者中金黄色葡萄球菌种类比例的降低是由总体样本中耐甲氧西林金黄色葡萄球菌（MRSA）比例的降低驱动的。
在过去 10 年中，我们中心骨折深部 SSI 的细菌学情况发生了重大变化，特别是 GNR、CoNS 和 MRSA 的比例。
预后 III 级。有关证据水平的完整描述，请参见作者说明。
