周围假肢关节感染的微生物学概况:来自北印度的回顾性分析
Souradeep Chowdhury1, Sunit Sikdar1, Rajesh Malhotra2
1Department of Medicine and Microbiology, All India Institute of Medical Sciences, New Delhi, India.
The American journal of tropical medicine and hygiene
|October 29, 2024
概括
假肢关节感染 (PJIs) 在关节置换手术后越来越令人担忧. 在印度,多抗药性阴性细菌是这些感染的主要原因,使治疗决策复杂化.
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:
- 假肢关节感染 (PJIs) 是全面关节整形术后的一个重要并发症,增加了患者的发病率.
- 致病原体和抗菌素耐药性模式的PJIs的频谱在地理上有所不同,影响经验抗生素选择.
- 抗药性生物体的增长率需要更新的流行病学数据,以有效管理PJI.
研究的目的:
- 在印度的一家三级医院中识别导致PJI的常见细菌生物.
- 确定该地区PJI病原体中多药耐药生物体 (MDRO) 的流行率.
- 了解格兰负PJI分离物中的特定耐药性模式,特别是碳烯耐药性.
主要方法:
- 对接受手术的骨科植入物患者记录的回顾性分析.
- 在手术期间采集组织样本进行超声波和随后的微生物培养.
- 进行了细菌分离物的鉴定和抗微生物敏感性测试.
主要成果:
- 最常见的分离物是黄金葡萄球菌 (16.3%),空气菌 (13.9%),表皮葡萄球菌 (12.8%) 和肺炎菌 (12.8%).
- 在PJI分离物体中观察到多种耐药生物的高流行率.
- 值得注意的是,35%的格拉姆阴性分离物表现出对碳烯胺的耐药性.
结论:
- 耐多药性阴性细菌是印度研究环境中假肢关节感染的主要驱动因素.
- 调查结果强调,迫切需要对PJI病原体和耐药性趋势进行区域监测.
- 目前在该地区实证治疗PJIs的抗生素策略需要仔细考虑局部耐药性模式,特别是对格兰氏阴性病原体.
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