CAJ | 학술논문

目的总结分析我院人工全髓关节置换术后晚期感染病例的细菌学特点及药敏特性,为临床治疗中抗生素的选择提供参考.方法选取自2002年1月至2010年8月解放军总医院骨科关节外科收治行翻修治疗的人工髋关节置换术后晚期感染患者共62例,选取术中可疑组织做细菌培养,对获得的细菌学种类、数量及药敏结果进行分析.结果本组患者共62例,术中培养阳性48例,革兰氏阳性菌共占74.06%,革兰阴性菌共占18.50%,真菌占7.40%.其中凝固酶阴性葡萄球菌占50%、金黄色葡萄球菌占12.96%;耐甲氧西林的葡萄球菌检出比率达41.18%.结论人工髋关节置换术后晚期感染的细菌主要由革兰阳性菌引起,耐药菌株的比例较高,应当根据药敏结果针对用药,万古霉素可作为感染治疗的一线药物.
목적 총결분석아원인공전수관절치환술후만기감염병례적세균학특점급약민특성,위림상치료중항생소적선택제공삼고.방법 선취자2002년1월지2010년8월해방군총의원골과관절외과수치행번수치료적인공관관절치환술후만기감염환자공62례,선취술중가의조직주세균배양,대획득적세균학충류、수량급약민결과진행분석.결과 본조환자공62례,술중배양양성48례,혁란씨양성균공점74.06%,혁란음성균공점18.50%,진균점7.40%.기중응고매음성포도구균점50%、금황색포도구균점12.96%;내갑양서림적포도구균검출비솔체41.18%.결론 인공관관절치환술후만기감염적세균주요유혁란양성균인기,내약균주적비례교고,응당근거약민결과침대용약,만고매소가작위감염치료적일선약물.
Objective To review the type and number of pathogens and their antibiotic sensitivity in patients with late infected total joint replacement so as to offer guidance for the choice of antibiotics.Methods A retrospective analysis was conducted for 62 patients whose suspected specimens were obtained intra-operatively during a total hip arthroplasty since January 2002 to August 2010 at our department. Their demographic data, bacterial species and antibiotic sensitivity profiles were recorded. Results Among 62cases, the cultures were tested positive in 48 cases; the most common bacteria was Gram-positive bacteria(74%). And coagulase-negative staphylococci and Staphylococcus aureus accounted for 62.9% of all bacterial cultures. And the ratio of methicillin-resistant Staphylococcus was 41.18% . Conclusion The late infection of total hip arthroplasty is mainly caused by Gram-positive bacteria. Antibiotic treatment for late periprosthetic infection should be guided by the findings of drug susceptibility. Vancomycin may be used as a primary agent for the treatment of infected hip arthropalaty.