外科创伤患者手术部位细菌性感染的流行:一项横断面研究。

IF 1.4 Q3 EMERGENCY MEDICINE International Journal of Burns and Trauma Pub Date : 2021-06-15 eCollection Date: 2021-01-01
Mehdi Motififard, Mehdi Teimouri, Kiana Shirani, Saeed Hatami, Mahila Yadegari
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引用次数: 0

摘要

背景与目的:手术部位感染是最常见的术后并发症之一。由于骨科手术部位感染的高发率,对细菌感染的频率分布及相关危险因素进行流行病学研究显得至关重要。在本研究中,我们旨在调查和评估创伤性手术患者中细菌感染的患病率。方法:这是一项横断面研究,对2011-2020年骨科手术后因手术部位感染再次入院的所有闭合性骨折创伤患者进行研究。从患者的病历资料中收集手术部位培养、抗生素谱和最有效抗生素的数据。结果:在本研究中,5950例患者接受了外伤性闭合性骨折手术,其中238例(4%)因感染再次入院。对157例患者的资料进行分析,发现46例患者最常见的感染部位为膝关节(29.3%)。检出革兰氏阳性菌55例(56.7%),革兰氏阴性菌42例(43.3%)。经统计分析,万古霉素是治疗葡萄球菌感染最有效的抗生素。在原始模型和调整模型中,胫骨损伤(OR = 1.18, P < 0.001)、膝关节损伤(OR = 1.50, P < 0.001)、葡萄球菌(OR = 1.50, P < 0.001)和肠杆菌(OR = 1.50, P < 0.001)的手术部位细菌感染的风险也显著增加。结论:感染检出率为4%,以金黄色葡萄球菌感染最为常见。万古霉素也是患者中最有效的抗生素。我们建议对预防性抗生素的使用进行更多的研究。
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Prevalence of Bacterial surgical site infection in traumatic patients undergoing orthopedic surgeries: a cross-sectional study.

Background and objective: Infection at the surgical site is one of the most common postoperative complications. Due to the high prevalence of orthopedic surgery site infection, epidemiologic studies that evaluate the frequency distribution of bacterial infection and related risk factors seem crucial. In the present study, we aimed to investigate and evaluate the prevalence of bacterial infections in traumatic operated patients.

Methods: This is a cross-sectional study that was performed in 2011-2020 on all trauma cases with closed fractures re-admitted to the traumatic referral hospital due to surgical site infection after orthopedic surgeries. Data regarding surgical site culture and antibiogram and the most effective antibiotics were also collected from medical documents of patients.

Results: During this study, 5950 people underwent traumatic closed fracture surgeries, of which 238 (4%) were readmitted due to infection. Data of 157 patients were analyzed and showed that the most common site of infection was knee in 46 patients (29.3%). Data also showed that gram-positive bacteria were detected in 55 patients (56.7%) while gram-negative micro-organisms were found in 42 patients (43.3%). Based on the statistical analysis, vancomycin was the most effective antibiotic in staphylococcus infections. There was also a significantly higher risks of bacterial surgical site infection for tibial injury (OR = 1.18, P < 0.001), knee injury (OR = 1.50, P < 0.001), presence of Staphylococcus (OR = 1.50, P < 0.001) and also Enterobacter (OR = 1.50, P < 0.001) both in the crude and adjusted models.

Conclusion: The prevalence rate of infection was 4% and the most common bacteria was Staphylococcus aureus. Vancomycin was also the most effective antibiotic in patients. We suggest that more studies should be conducted on the use of prophylactic antibiotics.

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