周围假肢关节感染:是时候想出盒子
Min-Cong He1,2, Augusto Ferrini2,3, Javad Parvizi2
1Third Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
概括
外科手术部位感染 (SSI),与周围假肢关节感染 (PJI) 一样,越来越多地与患者自己的微生物组有关. 针对这种内源微生物群提供了一个有希望的新策略来预防和管理这些感染.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 微生物组研究 微生物组研究
背景情况:
- 手术部位感染 (SSI),特别是围假肢关节感染 (PJI),在骨科中构成了重大的临床和经济挑战.
- 历史上,PJI被归因于外源性病原体,但最近的证据强调了患者内源性微生物组的作用.
- 预计全关节关节整形手术的发病率上升将增加PJI率,强调需要新的预防和治疗策略.
研究的目的:
- 审查PJI病因学的不断变化的理解,从外源转向内源.
- 探索针对患者微生物组的新型治疗策略,以预防和管理PJI.
主要方法:
- 关于PJI病原和微生物组的最新研究的文献综述.
- 分析新兴的治疗方法,包括抗生素,菌体治疗和微生物群调节.
主要成果:
- 有证据表明,来自皮肤,鼻腔和肠道微生物群的内源性病原体是PJI的重要贡献者.
- 免疫细胞介导的"特洛伊木马"机制与手术部位的细菌持久性有关.
- 新的治疗方法,如膜透性抗生素,菌体治疗,益生菌,益生菌和便微生物群移植,显示出有前途.
结论:
- 准内源微生物组代表了PJI管理中的范式转变.
- 调节宿主微生物组为改善骨科手术结果提供了一个有希望的前沿.
- 未来的研究应该专注于利用基于微生物组的干预措施来打击PJI.
相关概念视频
Endocarditis III: Medical Management
213
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
213
Acute Pyelonephritis II: Diagnostic Studies and Management
323
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
323
Healthcare Associated Infections II: Preventive Measures
3.6K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
3.6K
Endocarditis IV: Nursing Management
329
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
329
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
5.4K
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
5.4K
Endocarditis I: Introduction
398
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
398


