Cao Qianqian, Fan Panlong, Feng Jiawei, Cheng Tianmiao, Wang Xiaoyang, Cheng Cheng, Dai Zhipeng
Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China.
Department of Orthopedics, Henan Provincial People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, China.
Front Surg. 2025 Mar 13;12:1566689. doi: 10.3389/fsurg.2025.1566689. eCollection 2025.
The objective of this study was to preliminarily examine the demographic profiles, the spectrum of pathogenic bacteria, and the antibiotic resistance patterns among patients with periprosthetic joint infection (PJI), while also offering deeper insights into the microbiological characteristics specifically in diabetic patients with PJI.
A retrospective analysis of 278 patients diagnosed with PJI from January 2019 to December 2024 at our institution was performed. Demographic characteristics of the patients, the distribution of pathogenic bacteria, and data on antibiotic resistance were statistically analyzed employing the chi-square test and -test.
Gram-positive cocci comprised 56.6% of all pathogenic bacteria, whereas coagulase-negative staphylococci constituted 28.1% of the total. Throughout the study period, a significant decrease was observed in the proportion of rifampicin-resistant coagulase-negative staphylococci (CoNS), from 27.0% to 10.4%. Similarly, a marked decline was noted in the proportion of gentamicin-resistant Staphylococcus aureus, from 50.0% to 15.4%. Conversely, there was a dramatic increase in the proportion of amoxicillin-clavulanate-resistant gram-negative bacilli, from 23.1% to 64.7%. The incidence of fungal infections was notably higher among diabetic patients with PJI compared to their non-diabetic counterparts.
This study demonstrates that the distribution pattern of pathogenic bacteria and their antibiotic resistance profiles among patients with PJI undergoes continuous variation. Moreover, there exist significant differences in the distribution of pathogenic bacteria between those with diabetes and those without diabetes among PJI patients. This serves as a crucial theoretical foundation and empirical support for the rigorous and tailored development of anti-infective treatment strategies for patients with various types of PJI.
本研究的目的是初步调查人工关节周围感染（PJI）患者的人口统计学特征、病原菌谱和抗生素耐药模式，同时更深入地了解糖尿病合并PJI患者的微生物学特征。
对2019年1月至2024年12月在我院诊断为PJI的278例患者进行回顾性分析。采用卡方检验和t检验对患者的人口统计学特征、病原菌分布及抗生素耐药数据进行统计学分析。
革兰氏阳性球菌占所有病原菌的56.6%，而凝固酶阴性葡萄球菌占总数的28.1%。在整个研究期间，耐利福平凝固酶阴性葡萄球菌（CoNS）的比例从27.0%显著下降至10.4%。同样，耐庆大霉素金黄色葡萄球菌的比例从50.0%显著下降至15.4%。相反，耐阿莫西林 - 克拉维酸革兰氏阴性杆菌的比例从23.1%急剧增加至64.7%。与非糖尿病PJI患者相比，糖尿病PJI患者的真菌感染发生率明显更高。
本研究表明，PJI患者病原菌的分布模式及其抗生素耐药谱在不断变化。此外，PJI患者中糖尿病患者和非糖尿病患者的病原菌分布存在显著差异。这为针对各类PJI患者严谨且个性化地制定抗感染治疗策略提供了关键的理论基础和实证支持。
