开口骨折的细菌污染:中国东部的病原体和抗生素耐药性模式
Wanrun Zhong1, Yanmao Wang1, Hongshu Wang1
1Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200235, China.
Journal of personalized medicine
|May 27, 2023
概括
开放骨折的细菌感染是常见的. 大多数病原体仍然对当前的抗生素预防敏感,但二级骨折可能需要额外的格兰氏阴性覆盖在中国东部.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 开放式骨折带有细菌污染和随后感染的高风险.
- 细菌病原体及其抗生素耐药性模式随着时间的推移而演变,并且在地理位置上有所不同.
- 了解当地的细菌流行病学对于创伤护理中有效预防感染至关重要.
研究的目的:
- 为了确定开放的下肢骨折中的细菌谱.
- 分析抗生素耐药性模式与常用的预防药物.
- 评估中国东部目前抗生素预防指南的充分性.
主要方法:
- 一项回顾性多中心队列研究,涉及1348名患有下肢骨折的患者.
- 收集的数据包括伤害机制,Gustilo-Anderson分类,病原体和抗生素耐药性.
- 来自中国东部6个创伤中心 (2015-2017年) 的伤口培养和抗生素敏感性测试分析.
主要成果:
- 观察到54.8%的阳性细菌培养率,第三级骨折的比率更高 (59%).
- 根据EAST指南,72.7%的孤立病原体对预防性抗生素敏感.
- 奇诺隆和科特里莫克萨显示出最低的抗药率.
结论:
- 目前EAST对抗生素预防的指导方针对于许多中国东部的开口骨折患者来说是足够的.
- 额外的格拉姆阴性覆盖可能对II级开口骨折的患者有益.
- 对细菌耐药性的局部监测对于优化创伤感染预防至关重要.
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