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髋部骨折后金黄色葡萄球菌所致人工关节周围感染的诊断与预防:文献系统综述

Diagnosis and Prevention of Periprosthetic Joint Infections by Staphylococcus aureus after Hip Fracture: A Systematic Review of the Literature.

作者信息

Oliveira Bianca Gabriella de, Costa Victor Hugo Ruis da, Gama Igor Rodrigues, Beskow Murilo Halberstadt, Santos Elisson Rafael Silva Dos

机构信息

Departamento da Liga Acadêmica de Ortopedia e Traumatologia da UNIFACS, Universidade Salvador (UNIFACS), Salvador, BA, Brasil.

Serviço de Ortopedia e Traumatologia, Hospital Universitário de Canoas, Canoas, RS, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Mar 21;59(1):e21-e28. doi: 10.1055/s-0043-1776019. eCollection 2024 Feb.

Abstract

Hip arthroplasties are surgical procedures widely performed all over the world, seeking to return functionality, relieve pain, and improve the quality of life of patients affected by osteoarthritis, femoral neck fractures, osteonecrosis of the femoral head, among other etiologies. Periprosthetic joint infections are one of the most feared complications due to the high associated morbidity and mortality, with a high number of pathogens that may be associated with its etiology. The aim of the present study was to analyze aspects correlated with the occurrence of infection, diagnosis and prevention of periprosthetic joint infections in the hip associated with after corrective surgery for hip fractures. This is a systematic review of the literature carried out in the databases indexed in the Medical Literature Analysis and Retrieval System Online (MEDLINE) carried out in accordance with the precepts established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Twenty studies that addressed the diagnosis and prevention of periprosthetic joint infections after hip fractures were selected for analysis. It is observed that there is no consensus in the literature on preventive measures for the occurrence of such infectious processes. Among the risk factors for the occurrence and severity of infections by after hip arthroplasties, obesity, longer surgical time, older age, immunosuppression, recent use of antibiotics, and multicomorbidities were mentioned. The use of biomarkers for early diagnosis, as well as screening, decolonization, and antibiotic prophylaxis processes are among the preventive procedures proposed in the literature.

摘要

髋关节置换术是在全世界广泛开展的外科手术,旨在恢复功能、缓解疼痛并改善受骨关节炎、股骨颈骨折、股骨头坏死等病因影响的患者的生活质量。假体周围关节感染是最令人恐惧的并发症之一,因其具有较高的相关发病率和死亡率,且可能与其病因相关的病原体种类繁多。本研究的目的是分析与髋部骨折矫正手术后相关的假体周围关节感染的发生、诊断和预防相关的因素。这是一项根据系统评价和Meta分析的首选报告项目(PRISMA)方法所确立的原则,在医学文献分析与检索系统在线(MEDLINE)索引的数据库中进行的文献系统评价。选取了20项涉及髋部骨折后假体周围关节感染的诊断和预防的研究进行分析。可以观察到,文献中对于此类感染性过程发生的预防措施尚无共识。在髋关节置换术后感染发生和严重程度的风险因素中,提到了肥胖、手术时间较长、年龄较大、免疫抑制、近期使用抗生素以及多种合并症。文献中提出的预防措施包括使用生物标志物进行早期诊断以及筛查、去定植和抗生素预防等过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26a5/10957261/dfc6ca720ce0/10-1055-s-0043-1776019-i2200196en-1.jpg

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