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植入式骨科器械上无症状细菌定植的令人担忧的存在情况。

Worrying Presence of Asymptomatic Bacterial Colonisation on Implanted Orthopedic Devices.

作者信息

Previ Leonardo, Iorio Raffaele, Solmone Mariacarmela, Mazza Daniele, Marzilli Fabio, Di Niccolo Riccardo, Corsetti Federico, Viglietta Edoardo, Carrozzo Alessandro, Maffulli Nicola

机构信息

Orthopedics and Traumatology, Ospedale Sant'Andrea, Rome, ITA.

Microbiology, Ospedale Sant'Andrea, Rome, ITA.

出版信息

Cureus. 2024 Aug 29;16(8):e68126. doi: 10.7759/cureus.68126. eCollection 2024 Aug.

Abstract

Background Bacterial infection after hardware implantation in orthopedic and trauma surgery is devastating, resulting in increased hospital costs and stays, multiple revision surgeries, and prolonged use of antibiotics. The present study aims to determine whether a symbiotic relationship between the human organism and bacteria in hardware implantation may be present, without clinically evident infection. Materials and methods We studied explanted devices for microbiological analysis, using the sonication technique, from patients who underwent surgical removal of musculoskeletal hardware for mechanical reasons. None of the patients included in the study had clinical or biochemical signs of infection. Results Forty-nine patients were enrolled. Cultures tested positive for bacteria in 42.8% of the 49 patients (21 of 49). In 13 patients, Gram-positive bacteria were isolated, while Gram-negative bacteria were isolated from nine patients. The most frequent bacterial species found was , with six positive cultures (28.5%). Coagulase-negative staphylococci were isolated from ten implants (47%). Conclusion A pacific coexistence between humans and bacteria is possible following the implantation of metallic devices for trauma or orthopedic ailments. It is still unclear how strong or unstable this equilibrium is.

摘要

背景 在骨科和创伤手术中植入硬件后发生细菌感染是灾难性的,会导致医院成本增加、住院时间延长、多次翻修手术以及抗生素的长期使用。本研究旨在确定在硬件植入过程中人体与细菌之间是否可能存在共生关系,而无明显临床感染。材料与方法 我们对因机械原因接受肌肉骨骼硬件手术取出的患者的取出装置进行了微生物分析,采用超声处理技术。纳入研究的患者均无感染的临床或生化迹象。结果 共纳入49例患者。49例患者中有42.8%(21例)的培养物检测出细菌阳性。13例患者分离出革兰氏阳性菌,9例患者分离出革兰氏阴性菌。最常见的细菌种类是 ,有6份培养物呈阳性(28.5%)。凝固酶阴性葡萄球菌从10个植入物中分离出来(47%)。结论 在因创伤或骨科疾病植入金属装置后,人类与细菌之间可能存在和平共处。这种平衡有多稳固或多不稳定仍不清楚。

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