Svensson O, Parment P A, Blomgren G
Scand J Infect Dis. 1987;19(1):69-75. doi: 10.3109/00365548709032380.
In recent decades, Serratia marcescens has been established as a cause of infections difficult to treat, and several outbreaks of nosocomial infections have been reported, mostly from the USA. However, serratia infections affecting bones and joints are very rare; only a few such cases have previously been reported from Europe. We report 7 patients with orthopaedic infections by S. marcescens chiefly of nosocomial origin where previous antibiotic therapy apparently was a predisposing factor. The clinical course was generally protracted, often requiring repeated surgical interventions. Also, in some cases adequate therapy was considerably delayed as serratia was considered to be a nonpathogenic saprophyte. Multiresistance to antibiotics was a major clinical problem. However, the third generation cephalosporins are often effective against serratia and the aminoglycosides can thus be avoided. The increased use of prophylactic antibiotic therapy in orthopaedic surgery may bring about an increase in the incidence of infections by multiresistant microorganisms in orthopaedic wards.
近几十年来，粘质沙雷氏菌已被确认为难治性感染的病因，并且已报告了数起医院感染暴发事件，大多来自美国。然而，影响骨骼和关节的沙雷氏菌感染非常罕见；此前欧洲仅报告过少数此类病例。我们报告了7例主要由医院感染引起的粘质沙雷氏菌骨科感染患者，先前的抗生素治疗显然是一个诱发因素。临床病程通常迁延，常常需要反复进行手术干预。此外，在某些情况下，由于沙雷氏菌被认为是一种非致病性腐生菌，适当的治疗被大大延迟。对多种抗生素耐药是一个主要的临床问题。然而，第三代头孢菌素通常对沙雷氏菌有效，因此可以避免使用氨基糖苷类药物。骨科手术中预防性抗生素治疗的使用增加可能会导致骨科病房中多重耐药微生物感染的发生率上升。
