在周围假肢关节感染中患有难以治疗的病原体的超级感染的患病率和危险因素
Ali Darwich1, Tobias Baumgärtner1, Svetlana Hetjens2
1Department of Orthopedic and Trauma Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Antibiotics (Basel, Switzerland)
|August 28, 2025
概括
由难以治疗 (DTT) 病原体引起的周围假肢关节感染很常见,CRP升高和关节受影响的风险增加. 早期识别和量身定制的战略对于管理DTT PJI至关重要.
科学领域:
- 整形医学
- 传染性疾病
- 手术感染
背景情况:
- 周围假肢关节感染 (PJIs) 是全关节整形术后的严重并发症.
- 难以治疗 (DTT) 病原体在PJI管理中带来了重大挑战.
- 了解DTT PJI和超级感染的流行率和风险因素至关重要.
研究的目的:
- 评估DTT病原体引起的PJI的流行情况.
- 评估PJI与DTT病原体超级感染的发生率.
- 确定与DTT PJI和超级感染相关的风险因素.
主要方法:
- 对169名PJI患者进行的回顾性单中心观察研究.
- 将PJI分为DTT,DTT超级感染,非DTT和超级感染组.
- 分析患者的人口统计,临床参数 (BMI,CRP,ASA,CCI) 和感染特征.
主要成果:
- 46.2%的PJI是由DTT病原体引起的;30.8%涉及超级感染.
- 升高的CRP (≥92.1 mg/ L) 显著增加了DTT PJI的可能性 (OR 6. 981).
- 关节受影响 (OR 3. 478),≥3次修复手术 (OR 1. 288) 和慢性PJI (OR 3. 449) 与较高的DTT PJI/超级感染风险相关.
结论:
- 在PJI病例中DTT病原体和超级感染的高患病率.
- 增加的CRP,关节受损,多次修复和慢性感染是关键的危险因素.
- 强调需要及早识别高风险患者,并为DTT PJIs制定量身定制的管理策略.
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