Unsworth Annalise, Young Bernadette, Scarborough Matthew, McNally Martin
The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford OX3 7HE, UK.
St Vincent's Hospital Clinical School, University of New South Wales, Sydney 2010, Australia.
Antibiotics (Basel). 2024 Nov 23;13(12):1125. doi: 10.3390/antibiotics13121125.
: The microbiological profile of bone and joint infections is important for determining the empiric choice of both systemic and local antimicrobial therapy. This study assessed whether there was a difference in the bacterial species that were isolated on culture in osteomyelitis (OM), fracture-related infection (FRI) or prosthetic joint infection (PJI). This was a retrospective, observational cohort study of patients who had surgical intervention for PJI or OM or FRI with a positive microbial culture between 2019 and 2022. : Data including patient demographics, the site of injury, JS-BACH score, organism classification and antibiotic resistance to vancomycin and gentamicin were extracted from the medical records. : A total of 440 patients were included in this study: 163 patients with osteomyelitis, 109 with fracture-related infection with fixation implants and 168 with prosthetic joint infection. The patients with PJI were older, more likely to be female and had a higher BMI and ASA score compared to those with OM. Patients with PJI were more likely to have a higher JS-BACH score and more complex infections. was the most commonly isolated organism in all three groups. It was more frequently isolated in osteomyelitis than in PJI ( = 0.016). In both osteomyelitis and FRI, after the next most common organisms were Gram-negatives, whilst for PJIs, the most commonly isolated organisms were , followed by coagulase-negative and then species. The rates of other organisms were broadly similar between the three groups. When adjusted for confounders, including symptom duration, JS-BACH score, the location of injury, age and BMI, there was no statistically significant difference in the presence of (OR = 0.765; 95% CI 0.633-1.232; = 0.465) or polymicrobial infection (OR = 1.175; 95% CI 0.803-1.721; = 0.407). : Causative pathogens are similar across bone and joint infections and are independent of the presence of prosthetic material.
骨与关节感染的微生物学特征对于确定全身及局部抗菌治疗的经验性选择至关重要。本研究评估了在骨髓炎（OM）、骨折相关感染（FRI）或人工关节感染（PJI）中，培养分离出的细菌种类是否存在差异。这是一项回顾性观察队列研究，研究对象为2019年至2022年间因PJI、OM或FRI接受手术干预且微生物培养呈阳性的患者。：从病历中提取患者人口统计学数据、损伤部位、JS-BACH评分、微生物分类以及对万古霉素和庆大霉素的抗生素耐药性等数据。：本研究共纳入440例患者：163例骨髓炎患者，109例伴有固定植入物的骨折相关感染患者，168例人工关节感染患者。与OM患者相比，PJI患者年龄更大，女性比例更高，BMI和ASA评分更高。PJI患者更有可能具有更高的JS-BACH评分和更复杂的感染。是所有三组中最常分离出的微生物。其在骨髓炎中比在PJI中更频繁分离出来（=0.016）。在骨髓炎和FRI中，在之后，接下来最常见的微生物是革兰氏阴性菌，而对于PJI，最常分离出的微生物是，其次是凝固酶阴性菌，然后是菌属。三组中其他微生物的比例大致相似。在对包括症状持续时间、JS-BACH评分、损伤部位、年龄和BMI等混杂因素进行调整后，的存在（OR = 0.765；95% CI 0.633 - 1.232；= 0.465）或多微生物感染（OR = 1.175；95% CI 0.803 - 1.721；= 0.407）在统计学上无显著差异。：骨与关节感染的致病病原体相似，且与假体材料的存在无关。
