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某三级医院骨科器械植入中感染的患病率:一项观察性队列研究

Prevalence of Infections in the Implantation of Orthopedic Devices in a Third-Level Hospital: An Observational Cohort Study.

作者信息

Albavera-Gutierrez Roberto Renan, Espinosa-Ramos Manuel A, Rebolledo-Bello Ernesto, Paredes-Herrera Francisco Javier, Carballo-Lucero Daniel, Valencia-Ledezma Omar Esteban, Castro-Fuentes Carlos Alberto

机构信息

Traumatology and Orthopedics Unit, Hospital Regional de Alta Especialidad de Ixtapaluca, IMSS-BIENESTAR. Calle Gustavo E. Campa 54, Col. Guadalupe Inn, Alcaldía Álvaro Obregón, Ciudad de México C.P. 01020, Mexico.

Research Unit, Hospital Regional de Alta Especialidad de Ixtapaluca, IMSS-BIENESTAR. Calle Gustavo E. Campa 54, Col. Guadalupe Inn, Alcaldía Álvaro Obregón, Ciudad de México C.P. 01020, Mexico.

出版信息

Pathogens. 2024 Jul 26;13(8):620. doi: 10.3390/pathogens13080620.

DOI:10.3390/pathogens13080620
PMID:39204221
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11357249/
Abstract

Using orthopedic devices or prosthetic joints to treat various conditions is expected in a Traumatology and Orthopedics Unit. Recently, the materials used to build these different devices have evolved; however, pathogens can still infect these materials. Additionally, the immune system has limitations when defending against these pathogens, which results in bacterial infections like , () and (). A total of 276 patients who attended the Traumatology and Orthopedics Unit of our hospital from 1 June 2018 to 1 June 2019, were included in the present study. Our study analyzed the incidence of and other bacterial pathogens in the surgical sites of patients with orthopedic implants, as well as the most used types of implants and implant materials. The specimens obtained from the surgical sites of the patients were cultured in anaerobic and aerobic media for subsequent identification using their phenotypic characteristics. Subsequently, antibiotic susceptibility tests were performed to establish the appropriate treatment. The primary pathogens identified were (26.4%), followed by (21.0%) and (15.8%). The most commonly used implants were plates (41.7%), followed by endomedullary nails (20%), Kirschner wires (14.1%), and fixators (10.1%). As for the anatomical regions of the implants, the most frequent sites were the legs, followed by the thighs, wrists, and ankles. The pathogens were more susceptible to ciprofloxacin (95%), clindamycin (89%), and cefotaxime (86%). is the primary infectious agent in our hospital, with an incidence of 26.4% after the placement of orthopedic implants. Although its incidence was lower compared to other tertiary hospitals, it is necessary to improve aseptic techniques in such a way as to reduce the incidence of this pathogen further.

摘要

创伤骨科病房通常会使用矫形器械或人工关节来治疗各种病症。近年来,用于制造这些不同器械的材料不断发展;然而,病原体仍可感染这些材料。此外,免疫系统在抵御这些病原体时存在局限性,这会导致诸如[具体细菌感染名称1]、[具体细菌感染名称2]和[具体细菌感染名称3]等细菌感染。本研究纳入了2018年6月1日至2019年6月1日期间在我院创伤骨科病房就诊的276例患者。我们的研究分析了骨科植入物患者手术部位[具体细菌名称]和其他细菌病原体的发生率,以及最常用的植入物类型和植入材料。从患者手术部位获取的标本在厌氧和好氧培养基中培养,随后根据其表型特征进行鉴定。随后进行抗生素敏感性试验以确定合适的治疗方法。鉴定出的主要病原体为[具体细菌名称1](26.4%),其次是[具体细菌名称2](21.0%)和[具体细菌名称3](15.8%)。最常用的植入物是接骨板(41.7%),其次是髓内钉(20%)、克氏针(14.1%)和固定器(10.1%)。至于植入物的解剖部位,最常见的部位是腿部,其次是大腿、手腕和脚踝。病原体对环丙沙星(95%)、克林霉素(89%)和头孢噻肟(86%)更敏感。[具体细菌名称1]是我院主要的感染病原体,在骨科植入物置入后发生率为26.4%。尽管与其他三级医院相比其发生率较低,但仍有必要改进无菌技术以进一步降低该病原体的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/eb2c75bbf0f8/pathogens-13-00620-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/35c9eda973bc/pathogens-13-00620-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/ae1168ebae21/pathogens-13-00620-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/4d8ee9058283/pathogens-13-00620-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/eb2c75bbf0f8/pathogens-13-00620-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/35c9eda973bc/pathogens-13-00620-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/ae1168ebae21/pathogens-13-00620-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/ba99f9cea828/pathogens-13-00620-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/4d8ee9058283/pathogens-13-00620-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d51/11357249/eb2c75bbf0f8/pathogens-13-00620-g005.jpg

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