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接受骨科手术的创伤患者中细菌手术部位感染的患病率:一项横断面研究。

Prevalence of Bacterial surgical site infection in traumatic patients undergoing orthopedic surgeries: a cross-sectional study.

作者信息

Motififard Mehdi, Teimouri Mehdi, Shirani Kiana, Hatami Saeed, Yadegari Mahila

机构信息

Professor, Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Assistant Professor, Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine Isfahan, Iran.

出版信息

Int J Burns Trauma. 2021 Jun 15;11(3):191-196. eCollection 2021.

Abstract

BACKGROUND AND OBJECTIVE

Infection at the surgical site is one of the most common postoperative complications. Due to the high prevalence of orthopedic surgery site infection, epidemiologic studies that evaluate the frequency distribution of bacterial infection and related risk factors seem crucial. In the present study, we aimed to investigate and evaluate the prevalence of bacterial infections in traumatic operated patients.

METHODS

This is a cross-sectional study that was performed in 2011-2020 on all trauma cases with closed fractures re-admitted to the traumatic referral hospital due to surgical site infection after orthopedic surgeries. Data regarding surgical site culture and antibiogram and the most effective antibiotics were also collected from medical documents of patients.

RESULTS

During this study, 5950 people underwent traumatic closed fracture surgeries, of which 238 (4%) were readmitted due to infection. Data of 157 patients were analyzed and showed that the most common site of infection was knee in 46 patients (29.3%). Data also showed that gram-positive bacteria were detected in 55 patients (56.7%) while gram-negative micro-organisms were found in 42 patients (43.3%). Based on the statistical analysis, vancomycin was the most effective antibiotic in staphylococcus infections. There was also a significantly higher risks of bacterial surgical site infection for tibial injury (OR = 1.18, P < 0.001), knee injury (OR = 1.50, P < 0.001), presence of Staphylococcus (OR = 1.50, P < 0.001) and also Enterobacter (OR = 1.50, P < 0.001) both in the crude and adjusted models.

CONCLUSION

The prevalence rate of infection was 4% and the most common bacteria was Staphylococcus aureus. Vancomycin was also the most effective antibiotic in patients. We suggest that more studies should be conducted on the use of prophylactic antibiotics.

摘要

背景与目的

手术部位感染是最常见的术后并发症之一。由于骨科手术部位感染的发生率较高,评估细菌感染的频率分布及相关危险因素的流行病学研究显得至关重要。在本研究中,我们旨在调查和评估创伤手术患者中细菌感染的发生率。

方法

这是一项横断面研究,于2011年至2020年对所有因骨科手术后手术部位感染再次入住创伤转诊医院的闭合性骨折创伤病例进行。还从患者的医疗文件中收集了有关手术部位培养、抗菌谱和最有效的抗生素的数据。

结果

在本研究期间,5950人接受了创伤性闭合性骨折手术,其中238人(4%)因感染再次入院。对157例患者的数据进行分析,结果显示最常见的感染部位是膝关节,有46例患者(29.3%)。数据还显示,55例患者(56.7%)检测到革兰氏阳性菌,42例患者(43.3%)检测到革兰氏阴性微生物。基于统计分析,万古霉素是葡萄球菌感染中最有效的抗生素。在粗模型和校正模型中,胫骨损伤(OR = 1.18,P < 0.001)、膝关节损伤(OR = 1.50,P < 0.001)、存在葡萄球菌(OR = 1.50,P < 0.001)以及肠杆菌(OR = 1.50,P < 0.001)的患者发生细菌手术部位感染的风险也显著更高。

结论

感染发生率为4%,最常见的细菌是金黄色葡萄球菌。万古霉素也是患者中最有效的抗生素。我们建议应就预防性抗生素的使用开展更多研究。

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