膝关节置换术后感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing infections after knee arthroplasty

目的探讨膝关节置换术后关节腔感染的病原菌、耐药性以及影响患者预后的危险因素,以降低感染率。方法对医院收治的膝关节置换术后感染的98例患者作为试验组,选择同期未发生感染的200例患者作为对照组,并对感染患者的病原菌、耐药性及危险因素进行分析。结果分离出病原菌131株,其中革兰阴性菌占45.04%、革兰阳性菌占46.56%、真菌占8.40%;革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦、美罗培南等耐药率<10.0%;金黄色葡萄球菌和凝固酶阴性葡萄球菌对万古霉素的耐药率分别为10.71%、6.25%;备皮时间、术后引流、年龄、异体输血、住院时间、白蛋白含量、尿管滞留时间等是导致患者发生感染的独立危险因素。结论对于膝关节置换术患者发生感染时应及时进行病原学分析,并选择合理抗菌药物进行治疗,以提高患者预后。

OBJECTIVE To study the distribution and drug resistance of pathogens causing infections after knee arthoplasty and explore the influencing factors for prognosis so as to reduce the infection rate.METHODS Totally 98 patients who underwent the knee arthroplasty in the hospital and were with postoperative infections were chosen as the study group,while 200 patients without postoperative infections were set as the control group,then the distribution and drug resistance of the pathogens causing infections as well as the risk factors were analyzed. RESULTS A total of 131strains of pathogens have been isolated,among which the gram-negative bacteria accounted for 45.04%,the gram-positive bacteria 46.56%,the fungi 8.40%.TH drug resistance rates of the gram-negative bacteria to imipenem,cefoperazone-sulbactam,and meropenem were less than 10.0%;the drug resistance rates of the Staphylococcus aureus and coagulase-negative Staphylococcus to vancomycin were 10.71% and 6.25%,respectively.The skin preparation time,postoperative drainage,age,allogeneic blood transfusion,hospitalization duration,level of albumin,and catheter indwelling time were the independent risk factors for the postoperative infections.CONCLUSIONIt is an effective way to perform the etiological analysis of the infections in the knee arthroplasty patients in a timely manner and to use antibiotics reasonably so as to improve the prognosis.