对于周围假肢关节感染的生物体概况和经验治疗方法
Gongan Jiang1,2, Weijun Wang1,2, Yuhao Yang1,2
1Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu, 210008, PR China.
Journal of orthopaedic surgery and research
|July 27, 2025
概括
这项研究分析了引起周围假肢关节感染 (PJI) 的病原体及其对抗生素的敏感性,以指导实证治疗. 建议在慢性PJI治疗中使用万科米辛和美罗胺组合,而在急性PJI治疗中建议使用万科米辛和塞夫塔齐迪姆.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 周围假肢关节感染 (PJI) 是关节关节整形术的严重并发症.
- 准确的病原体识别和抗生素敏感性数据对于有效的PJI治疗至关重要.
- 经验性抗生素疗法通常是必要的,因为缺乏即时的微生物信息.
研究的目的:
- 为PJI开发区域特定的抗菌药物方案.
- 分析PJI患者的病原体概况和抗生素敏感性.
- 为PJI提供经验性抗生素治疗策略提供参考.
主要方法:
- 在2018年1月至2024年12月期间治疗的255名PJI患者的回顾性分析.
- 关节液体和组织样本进行培养,以鉴定病原体.
- 分析了病原体分布,抗菌素耐药性模式和抗生素有效覆盖率.
主要成果:
- 格拉姆阳性细菌,特别是凝血酶阴性葡萄球菌 (65.1%) 和葡萄球菌表皮菌 (25.7%),是最常见的病原体.
- 观察到高水平的甲素耐药性 (48.1%) 和多药耐药性 (57.6%).
- 香草素和美罗胺对慢性PJI (95.5%) 的疗效很高,而香草素和塞夫塔齐迪姆对急性PJI (98.4%) 的疗效很高.
结论:
- 格拉姆阳性细菌主导PJI病例,表现出显著的抗菌素耐药性.
- 范科米辛加梅罗是培养负慢性PJI的推实证治疗方案.
- 建议在培养负的急性术后PJI中使用万科米辛加塞夫塔齐迪姆.
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