脊柱外科感染临床流行病学及影响因素

Analysis of clinical epidemiology and influencing factors of infection in spinal surgery

目的探讨脊柱外科感染临床流行病学及影响因素。方法回顾性分析2014年1月-2019年11月中山大学附属第三医院脊柱外科收治的脊柱感染患者91例的临床资料,对脊柱外科感染的人口学特点、感染时间分布情况进行分析,同时选取同期收治的非感染患者83例为未感染组,分析两组患者的临床资料,归纳脊柱外科患者感染的影响因素。结果91例脊柱感染患者中特异性感染患者38例(41.76%),非特异性感染患者53例(58.24%),≥60岁37例(40.66%),男性57例(62.64%),中学文化程度56例(61.54%),工人20例(21.98%),腰椎感染55例(60.44%);2014-2019年脊柱外科感染例数分别为16例(17.58%)、3例(3.30%)、20例(21.98%)、15例(16.48%)、16例(17.58%)、21例(23.08%),特异性感染患者、非特异性感染患者的人口学特点、感染时间分布及脊柱感染情况,差异均无统计学意义;共培养分离病原菌74株,结核分枝杆菌36株(48.65%)、金黄色葡萄球菌12株(16.22%)、布鲁氏菌5株(6.76%)、大肠埃希菌5株(6.76%);年龄、糖尿病、肺部疾病、脊柱手术史、体质量指数(BMI)是脊柱外科患者感染的影响因素(P<0.05)。结论脊柱感染患者以男性、中学文化程度、腰椎感染构成比较大,2014-2019年脊柱感染时间分布呈波浪式增长,结核分枝杆菌与金黄色葡萄球菌是脊柱感染的主要病原菌,应对高龄、肥胖、糖尿病、肺部疾病以及有脊柱手术史的患者予以关注。

OBJECTIVE To investigate the clinical epidemiology and influencing factors of infection in spinal surgery.METHODS The clinical data of 91 patients with spinal infection admitted to spinal surgery of the Third Affiliated Hospital of Sun Yat-sen University from Jan.2014 to Nov.2019 were retrospectively analyzed.The demographic characteristics and infection time distribution of spinal surgery infection were analyzed.Another 83 non-infection patients who were admitted during the same period were selected as the non-infection group.The clinical data in both groups of patients were analyzed and the influencing factors of spinal surgery infection were summarized.RESULTS Among the 91 patients with spinal infection,there were 38(41.76%)cases with specific infection,53(58.24%)cases with non-specific infection,and 37(40.66%)cases no younger than 60 years old,57(62.64%)cases of male gender,56 cases(61.54%)with middle school education level,20(21.98%)cases with worker occupation and 55 cases(60.44%)with lumbar infection.The number of infections in spinal surgery from 2014-2019 were 16 cases(17.58%),3 cases(3.30%),20 cases(21.98%),15 cases(16.48%),16 cases(17.58%)and 21 cases(23.08%),respectively.There were no significant differences in demographic characterustics,infection time distribution and spinal infection distribution between specific infection group and non-specific infection group.There were 74 strains of pathogens cultured and isolated,including 36 strains of Tuberculous bacillus(48.65%),12 strains of Staphylococcus aureus(16.22%),5 strains of Brucella(6.76%)and 3 strains of Escherichia coli(4.05%).The age,diabetes,pulmonary disease,history of spinal surgery and body mass index(BMI)were influencing factors of spinal surgery infection(P<0.05).CONCLUSION The ratio of spinal infection was relatively higher in patients with male gender,middle school education level and lumbar infection.From 2014-2019,time distribution of spinal infection showed a wave-like growth.Tuberculous bacillus and Staphylococcus aureus were the main pathogens of spinal infection.Attention should be paid to patients with advanced age,obesity,diabetes,pulmonary disease and history of spinal surgery.