[1]王行旺 谢再利 张亚伟.老年全髋关节置换术后感染的病原菌分布和耐药性分析[J].中国中医骨伤科杂志,2020,28(05):35-38.
　WANG Xingwang XIE Zaili ZHANG Yawei.Distribution and Drug Resistance of Pathogenic Bacteria in ElderlyPatients with Infection after Total Hip Arthroplasty[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(05):35-38.
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老年全髋关节置换术后感染的病原菌分布和耐药性分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年05期
页码:
35-38
栏目:
临床论著
出版日期:
2020-05-10

文章信息/Info

Title:
Distribution and Drug Resistance of Pathogenic Bacteria in ElderlyPatients with Infection after Total Hip Arthroplasty
文章编号:
1005-0205(2020)05-0035-04
作者:
王行旺1 谢再利1 张亚伟1
1中南大学湘雅医学院附属海口医院感染和疾病控制处(海口,570208)
Author(s):
WANG Xingwang1 XIE Zaili1 ZHANG Yawei1
sup>1Haikou Hospital Affiliated to Xiangya School of Medicine,Central South University,Haikou 570208,China.
关键词:
全髋关节置换术;  耐药性;  单因素分析;  危险因素
Keywords:
total hip replacement;  drug resistance;  univariate analysis;  hazards
分类号:
R684.3
文献标志码:
A
摘要:
目的:分析老年全髋关节置换术后感染的病原菌分布和耐药性,并对感染风险因素进行分析。方法:回顾性分析2013年1月至2018年12月352例接受全髋关节置换术患者的临床资料,观察术后的感染率、病原菌分布、耐药性并分析发生感染的相关危险因素。结果:352例老年患者术后感染33例,感染率9.38%。共检出病原菌60株,其中革兰氏阳性菌35株(占58.33%),革兰氏阴性菌25株(占41.67%)。主要革兰氏阳性菌中金黄色葡萄球菌对青霉素、氨苄西林、苯唑西林的耐药率较高(>60%),凝固酶阴性葡萄球菌对青霉素、左氧氟沙星、苯唑西林的耐药率较高(>70%); 主要革兰氏阴性菌中大肠埃希菌对头孢唑林、氨苄西林的耐药率较高(>70%),铜绿假单胞菌对阿莫西林、磺胺甲恶唑的耐药率较高(>60%)。单因素和多因素分析,患者的年龄>60岁、合并基础疾病≥2种、有既往手术史、手术时间>3 h、抗菌药物使用种类>3种,是导致术后感染的独立危险因素(P<0.05)。结论:老年全髋关节置换术后发生院内感染的因素较多,且感染病原菌对多种抗生素耐药,应当合理选择抗菌药物并针对危险因素采取相应的预防措施,降低感染发生率。
Abstract:
Objective:To analyze the distribution and drug resistance of pathogens in the elderly patients after total hip arthroplasty, and to analyze the risk factors of infection.Methods:Clinical data of 352 patients undergoing total hip arthroplasty were retrospectively analyzed from January 2013 to December 2018. The infection rate, pathogen distribution, drug resistance and risk factors of infection were observed and recorded in elderly patients after total hip arthroplasty(THR). Single factor analysis and multi-factor logistic regression analysis were carried out by software.Results:The infection rate was 9.38%(33/352),35 strains(58.33%)were Gram-positive bacteria and 25 strains(41.67%)were Gram-negative bacteria.The resistance rate of Staphylococcus aureus to penicillin, ampicillin and oxacillin was more than 60%. The resistance rate of coagulase negative staphylococci to penicillin, levofloxacin and oxacillin was more than 70%. The resistance rate of Escherichia coli to cefazolin and ampicillin was more than 70%. The resistance rate of Pseudomonas aeruginosa to amoxicillin and sulfamethoxazole was more than 60%.Univariate and multivariate analysis showed that age>60 years old, combined with basic diseases(>2 kinds), previous operation history, operation time > 3 h, and types of antibiotics use > 3 kinds were independent risk factors for postoperative infection(P<0.05).Conclusion:There are many factors of nosocomial infection after total hip arthroplasty in the elderly, and the pathogens of the infection are resistant to many antibiotics. The antibiotics should be selected reasonably and the corresponding preventive measures should be taken according to the risk factors in order to reduce the incidence of infection.

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备注/Memo

备注/Memo:
(收稿日期:2020-02-02)
更新日期/Last Update: 2020-05-10