欧洲人工关节置换术后假体关节周围感染的细菌学分析

Bacteriological analysis of prosthetic joint infection after artificial joint replacement in Europe

目的分析欧洲人工关节置换术后假体周围感染病例的细菌学特点,以期为临床诊断、治疗该病提供参考。方法检索2011~2016年欧洲有关人工关节(髋、膝、肩)置换术后假体周围感染的文献,统计分析有关假体关节感染的发生情况。结果共有30篇文献入选,膝关节和髋关节感染病例以凝固酶阴性葡萄球菌和金黄色葡萄球菌最为多见,肩关节感染以丙酸杆菌最为多见。结论成功防治假体周围感染的关键在于多学科团队合作,即需要微生物学家、传染病专家、骨科医生和创伤外科医生联合采取预防措施和诊断,严格按照细菌培养和药敏实验的结果,避免增加细菌耐药,合理选择抗生素结合外科手术,最终实现根除感染、无痛、保留关节功能。

Objective To analyze the bacteriological characteristics in the patients with prosthetic joint infection after ar-tificial joint replacement in Europe so as to provide reference for its clinical diagnosis and treatment. Methods The medical literatures about prosthetic joint infection（hip,knee,shoulder） after artificial joint replacement in Europe from 2011 to 2016 were retrieved. The incidence of prosthetic joint infection was statistically analyzed. Results Thirty articles met the inclusion criteria,in the cases of knee and hip infection,the majority were coagulase-negative staphylococci and Staphylococcus aureus,while Propionibacterium was most common in shoulder infection. Conclusion The key for successfully preventing and treating prosthetic joint infection lies in the multiple disciplinary team collaboration,the microbiologists,infectious disease specialists,orthopedists and traumatic surgeons jointly adopt the preventive measures and diagnosis,strictly accord with bacterial culture and drug susceptibility test results,avoid to increase the drug resistance,rationally select antibiotics and combine with surgical operation for finally realizing to eradicate infection and preserve joint function without any pain.