Henriksen B M, Albrektsen S B, Simper L B, Gutschik E
Department of Orthopedics, Bispebjerg Hospital, Copenhagen, Denmark.
Acta Orthop Scand. 1994 Dec;65(6):625-8. doi: 10.3109/17453679408994618.
We evaluated clinical and microbiological aspects in 145 hospitalizations of 89 intravenous drug abusers with acute soft tissue infections at the injection site. There were 58 superficial abscesses, 27 deep abscesses, 57 cellulitis with or without concomitant ulcer, 1 purulent arthritis, 1 tenosynovitis and 1 incompletely categorized abscess. The commonest location was the groin. Serious complications occurred in 17 cases, including 4 lower-extremity amputations due to arterial lesions. There was a predominance of polybacterial infections (53 percent polybacterial, 38 percent monobacterial, 9 percent sterile). The commonest bacteria isolates were Streptococcus species with a preponderance of oropharyngeal bacteria, Staphylococcus aureus, and anaerobes, especially Bacteroides species. Typical intestinal bacteria were rare. In addition to surgical treatment we recommend that aerobic and anaerobic culturing with susceptibility tests always are carried out, that primary antibacterial therapy should consist of an antistaphylococcal agent, such as dicloxacillin plus metronidazole, and that free injection paraphernalia with disinfection swabs are easily available.
我们评估了89名静脉注射吸毒者因注射部位急性软组织感染而住院145次的临床和微生物学情况。其中有58例浅表脓肿、27例深部脓肿、57例伴有或不伴有溃疡的蜂窝织炎、1例化脓性关节炎、1例腱鞘炎以及1例分类不明确的脓肿。最常见的部位是腹股沟。17例出现严重并发症，包括4例因动脉病变导致的下肢截肢。多菌感染占主导（53%为多菌感染，38%为单菌感染，9%无菌）。最常见的分离细菌是链球菌属，以口咽部细菌为主，还有金黄色葡萄球菌和厌氧菌，尤其是拟杆菌属。典型的肠道细菌很少见。除手术治疗外，我们建议始终进行需氧菌和厌氧菌培养及药敏试验，初始抗菌治疗应包括一种抗葡萄球菌药物，如双氯西林加甲硝唑，并且应易于获取配有消毒棉签的一次性注射用具。
