Hu Lifeng, Fu Jun, Zhou Yonggang, Chai Wei, Zhang Guoqiang, Hao Libo, Chen Jiying
Medical School of Chinese PLA, Beijing, China.
Department of Orthopedics, The Fifth Central Hospital of Tianjin, Tianjin, China.
J Int Med Res. 2021 Mar;49(3):3000605211002784. doi: 10.1177/03000605211002784.
This study examined the trends in demographics, the distribution of microorganisms, and antibiotic resistance in patients with periprosthetic joint infection (PJI).
We conducted a retrospective study of 231 consecutive patients diagnosed with PJI in our hospital from January 2006 to December 2015 (93 and 138 patients diagnosed in 2006-2010 and 2011-2015, respectively). The linear-by-linear chi-squared test was used to assess the trends in demographics, the distribution of microorganisms, and antibiotic resistance.
Gram-positive cocci accounted for 63.9% of all pathogens, and coagulase-negative (CoNS) accounted for 38.1% of all isolates. The proportion of isolates identified as methicillin-resistant CoNS significantly increased over the study period (39.0% vs. 61.8%). In addition, the proportions of levofloxacin-resistant CoNS (4.9% vs. 21.8%) and (6.3% vs. 45.0%) isolates significantly increased over the study period. By contrast, the proportions of penicillin-resistant CoNS (82.9% vs. 40.0%) and (75.0% vs. 30.0%) isolates decreased over the study period.
Our research revealed changes in the distribution of microorganisms and antibiotic resistance profile of the pathogens responsible for PJI over time, which could complicate treatment. These findings may serve as a reference for strategies to prevent and empirically treat PJI in China.
本研究调查了人工关节假体周围感染（PJI）患者的人口统计学趋势、微生物分布及抗生素耐药情况。
我们对2006年1月至2015年12月在我院连续诊断为PJI的231例患者进行了回顾性研究（2006 - 2010年和2011 - 2015年分别诊断出93例和138例患者）。采用线性 - 线性卡方检验评估人口统计学趋势、微生物分布及抗生素耐药情况。
革兰氏阳性球菌占所有病原体的63.9%，凝固酶阴性葡萄球菌（CoNS）占所有分离菌株的38.1%。在研究期间，鉴定为耐甲氧西林CoNS的分离菌株比例显著增加（39.0%对61.8%）。此外，耐左氧氟沙星CoNS的分离菌株比例（4.9%对21.8%）和……（此处原文缺失部分内容）的分离菌株比例在研究期间也显著增加。相比之下，耐青霉素CoNS的分离菌株比例（82.9%对40.0%）和……（此处原文缺失部分内容）的分离菌株比例在研究期间下降。
我们的研究揭示了随着时间推移，导致PJI的病原体微生物分布及抗生素耐药情况发生了变化，这可能使治疗变得复杂。这些发现可为中国预防和经验性治疗PJI的策略提供参考。
