Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Clinical Laboratory, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
BMC Infect Dis. 2023 Aug 31;23(1):567. doi: 10.1186/s12879-023-08471-x.
This study assessed the distribution characteristics of pathogens isolated from cases of orthopedic infections and focused on the antimicrobial susceptibility of the main pathogens.
This retrospective study involved patients with orthopedic infection in a tertiary medical center located in Shanghai, China, from 2008 to 2021.Pathogen information and the basic information of patients were identified from clinical microbiology laboratory data and the institutional medical record system.
In total, the pathogen information of 2821 patients were enrolled in the study. S. aureus (37.71%) was the main causative pathogen responsible for orthopedic infection. Gender, pathogens distribution and polymicrobial infection rates were significantly different (P < 0.05) among patients with different orthopedic infection diseases.The trends in the distribution of pathogens in the total cohort, implant-related infection group (Group A), non-implant-related infection group (Group B), and the sub-group of cases with arthroplasty showed significant linear changes over time. And the polymicrobial infection rates of the total cohort (from 17.17% to 11.00%), Group B(from 24.35% to 14.47%), and the sub-group of cases with internal fixation (from 10.58% to 4.87%) decreased significantly. The antimicrobial susceptibility showed changing trends with time for some main pathogens, especially for S.aureus and Enterobacter spp.
Our research indicated that the pathogen distribution and antimicrobial susceptibility in orthopedic infections changed over time. And the distribution of pathogens varied significantly among different types of orthopedic infectious diseases. These findings may serve as a reference for prophylaxis and empirical treatment strategies of orthopedic infection.
本研究评估了骨科感染病例中分离出的病原体的分布特征，并重点关注主要病原体的抗菌药物敏感性。
本回顾性研究纳入了 2008 年至 2021 年期间在中国上海一家三级医疗中心就诊的骨科感染患者。从临床微生物学实验室数据和机构病历系统中确定了病原体信息和患者的基本信息。
本研究共纳入了 2821 例患者的病原体信息。金黄色葡萄球菌（37.71%）是导致骨科感染的主要病原体。不同骨科感染疾病患者的性别、病原体分布和混合感染率存在显著差异（P<0.05）。在总队列、植入物相关感染组（A 组）、非植入物相关感染组（B 组）以及关节置换亚组中，病原体分布的趋势随时间呈显著线性变化。总队列（从 17.17%降至 11.00%）、B 组（从 24.35%降至 14.47%）和内固定亚组（从 10.58%降至 4.87%）的混合感染率显著下降。一些主要病原体的抗菌药物敏感性随时间呈现出变化趋势，尤其是金黄色葡萄球菌和肠杆菌属。
本研究表明，骨科感染中的病原体分布和抗菌药物敏感性随时间发生变化。不同类型的骨科感染疾病之间病原体的分布存在显著差异。这些发现可为骨科感染的预防和经验性治疗策略提供参考。
