Orthopcdics Department of Tai'an Central Hospital, Tai'an, Shandong 271000, China.
The University of Georgia, Athens, GA, USA.
J Healthc Eng. 2022 Jan 27;2022:2114661. doi: 10.1155/2022/2114661. eCollection 2022.
To study the distribution and risk factors of multidrug-resistant bacteria (MDROS) infection in orthopedic patients and to provide reference for clinical prevention and control measures.
The data of 239 inpatients with orthopedic trauma from June 2019 to December 2020 were selected as the research objects, and the distribution characteristics of MDROS infection were analyzed through the real-time monitoring system of nosocomial infection. Logistic regression analysis was used to screen out the risk factors causing MDROS infection, and the preventive measures were put forward.
178 strains of pathogens were isolated from 239 patients, including 53 strains of MDROS, and the detection rate was 29.78%. The main pathogenic bacteria were ESBLs, MRSA, CRAB, CRE, and MDR/PDRPA. The main infection sites of MDROS in orthopedic patients were the respiratory tract and wound. No CRE1 was detected, and 64.39%, 17.42%, and 14.39% of ESBL-producing bacteria, MRSA, and MDR/PDRPA, respectively, were detected. Logistic multivariate analysis showed that the length of hospital stay, antibiotic use time, open injury, and serum albumin level were independent risk factors of MDROS infection in orthopedic trauma patients.
To prevent MDROS infection in orthopedic patients, we should start from many aspects, focusing on reducing unnecessary hospitalization days, rationally preventing the use of antibacterial drugs, effectively treating basic diseases, etc., timely and effective thorough debridement, strengthening functional training, reducing bed rest, and strengthening targeted monitoring of related infections which are the keys to reduce MDROS infection in orthopedic patients.
研究骨科患者多药耐药菌（MDROS）感染的分布及危险因素，为临床防控措施提供参考。
选取 2019 年 6 月至 2020 年 12 月骨科创伤住院患者 239 例为研究对象，通过医院感染实时监测系统分析 MDROS 感染分布特点，采用 logistic 回归分析筛选出导致 MDROS 感染的危险因素，并提出防控措施。
239 例患者共分离出病原菌 178 株，其中 MDROS 53 株，检出率为 29.78%。主要病原菌为 ESBLs、MRSA、CRAB、CRE、MDR/PDRPA，骨科患者 MDROS 主要感染部位为呼吸道和伤口。未检出 CRE1，产 ESBLs、MRSA、MDR/PDRPA 分别占 64.39%、17.42%、14.39%。logistic 多因素分析显示，住院时间、抗生素使用时间、开放性损伤、血清白蛋白水平是骨科创伤患者 MDROS 感染的独立危险因素。
预防骨科患者 MDROS 感染应从多方面入手，重点减少不必要的住院天数、合理预防抗菌药物的使用、有效治疗基础疾病等，及时有效的彻底清创、加强功能训练、减少卧床时间，并加强对相关感染的针对性监测，这些是降低骨科患者 MDROS 感染的关键。
