败血性关节炎和假肢关节感染:微生物谱和不断变化的耐药性模式
Merve Gürler1, Füsun Kırca1, Bedia Dinç1
1Ankara Bilkent City Hospital, Department of Medical Microbiology, Ankara, Türkiye.
Journal of bone and joint infection
|March 2, 2026
概括
葡萄球菌是造成败血性关节炎和假肢关节感染的主要原因. 抗生素耐药性增加需要谨慎治疗,但最后一线药物仍然有效地对抗葡萄球菌.
科学领域:
- 肌肉骨感染 肌肉骨感染
- 微生物学 微生物学
- 传染性疾病 传染性疾病
背景情况:
- 败血性关节炎 (SA) 和假肢关节感染 (PJI) 是严重的肌肉骨紧急情况.
- 准确的微生物学诊断具有挑战性,特别是在PJIs中,由于生物膜的形成.
- 地方流行病学数据对于优化实证治疗和管理至关重要.
研究的目的:
- 为了确定微生物在突液培养中的分布.
- 评估SA和PJI在五年内抗菌素耐药性的趋势.
- 为了比较本地SA和PJI之间的微生物模式.
主要方法:
- 对3171个突液样本 (2020-2024) 的回顾性分析.
- 使用MALDI-TOF进行微生物识别 MS.
- 通过VITEK-2 (EUCAST标准) 进行抗菌敏感性测试.
主要成果:
- 整体阳性率为20.5%; 血液培养瓶的阳性率更高 (29.6%).
- 黄金葡萄球菌 (33.6%),冠状病毒 (24.9%) 和 Pseudomonas aeruginosa (8.6%) 是最常见的.
- 凝聚酶阴性葡萄球菌 (CoNS) 和菌 (Enterococcus faecalis) 在PJI中更为常见. 甲素耐药性在S. aureus中增加;ESBL患病率在K. pneumoniae中增加,在E. coli中仍然很高.
结论:
- 葡萄球菌在关节感染中占主导地位,其中CoNS和E. faecalis与PJI有关.
- 增加的甲素耐药性和产生ESBL的肠杆菌需要仔细的经验性抗生素选择.
- 保持葡萄球菌对最后一线药物 (糖,线,达普托米辛) 的敏感性是令人鼓舞的.
- 将样本注射到血培瓶中可以提高诊断产量.
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