Liu Yuyang, Chen Peisheng, Lin Fengfei
Department of Orthopaedics, Fuzhou Second General Hospital, School of Clinical Medicine, Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopedic Trauma, Fujian Medical University, Fuzhou, 350007, Fujian, China.
The Second Clinical Medical College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
BMC Musculoskelet Disord. 2025 Jun 5;26(1):560. doi: 10.1186/s12891-025-08806-6.
This study was to elucidate the clinical characteristics and antibiotic susceptibility of orthopedic infections caused by Aeromonas hydrophila, thereby providing a suggestion for early clinical recognition and optimized managementof such infections in orthopedic clinical practice.
A retrospective investigation was conducted by collecting general patient information, specimen sources, culture results, and antibiotic susceptibility data from 58 cases of Aeromonas hydrophila infections treated at our hospital between November 2020 and April 2024.
The 58 patients with Aeromonas hydrophila infections had a mean age of (50.05 ± 14.97) years, and the majority were workers. 56 cases were associated with traumatic open wounds, with injuries primarily caused by mechanical crushing or lacerations. The patients had an average hospital stay of approximately 33.97 days and underwent an average of 2.66 surgical procedures. In 5.17% of the cases, due to severe limb damage rendering replantation impossible, emergency amputations were performed shortly after admission. 23 cases eventually met the clinical cure criteria, and after improvement, were discharged; however, 5 cases experienced recurrences. 18 cases were monomicrobial A. hydrophila infections, while the remaining 40 cases showed polymicrobial involvement with at least one additional pathogen. Antibiotic susceptibility tests indicated low resistance rates of A. hydrophila to amikacin, aztreonam, cefpirome, and cefoperazone, whereas resistance rates to cefazolin and ampicillin were higher, with all specimens being resistant to ampicillin.
Orthopedic infections caused by Aeromonas hydrophila predominantly affect middle-aged male industrial and agricultural workers, with the infection risk strongly associated with environmental exposure complexity during injury, particularly during mechanical operations and farming activities. Once infected, the disease progresses rapidly and severely, necessitating multiple surgical interventions. For antibiotic therapy, aminoglycosides and third- or fourth-generation cephalosporins are recommended treatment options, whereas first-generation cephalosporins should be avoided as first-line anti-infective agents.
本研究旨在阐明嗜水气单胞菌引起的骨科感染的临床特征及抗生素敏感性，从而为骨科临床实践中此类感染的早期临床识别和优化管理提供建议。
通过收集2020年11月至2024年4月在我院接受治疗的58例嗜水气单胞菌感染患者的一般信息、标本来源、培养结果及抗生素敏感性数据进行回顾性调查。
58例嗜水气单胞菌感染患者的平均年龄为（50.05±14.97）岁，以工人为主。56例与创伤性开放性伤口有关，损伤主要由机械挤压或撕裂伤引起。患者平均住院时间约为33.97天，平均接受2.66次外科手术。5.17%的病例因肢体严重损伤无法再植，入院后不久即行急诊截肢。23例最终达到临床治愈标准，好转后出院；然而，5例复发。18例为嗜水气单胞菌单一菌感染，其余40例显示多菌感染，至少伴有一种其他病原体。抗生素敏感性试验表明，嗜水气单胞菌对阿米卡星、氨曲南、头孢匹罗和头孢哌酮的耐药率较低，而对头孢唑林和氨苄西林的耐药率较高，所有标本均对氨苄西林耐药。
嗜水气单胞菌引起的骨科感染主要影响中老年男性工农业劳动者，感染风险与受伤时环境暴露复杂性密切相关，尤其是在机械操作和农业活动期间。一旦感染，病情进展迅速且严重，需要多次手术干预。对于抗生素治疗，推荐使用氨基糖苷类和第三代或第四代头孢菌素作为治疗选择，而应避免将第一代头孢菌素作为一线抗感染药物。
