IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Stephen Christopher Murphy, Shane P Russell, James A Harty, Padhraig O'Loughlin
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引用次数: 0

摘要

背景:人工关节感染(PJI)是关节置换手术的潜在灾难性后果。了解致病微生物和抗菌药的敏感性可提高根除 PJI 的成功率:1)观察一家三级转诊关节成形术单位的 PJI 微生物群;2)与已发表的类似观察结果进行比较;3)制定经验性局部抗生素 PJI 指南:方法:纳入4年内所有组织培养阳性的PJI患者。对电子微生物实验室数据库进行搜索,以确定分离出的微生物、敏感性和耐药性。记录了从指数手术到 PJI 发病的时间。将确定的 PJI 微生物组与现有文献进行比较:结果:共纳入 86 名患者,涉及 88 个关节。56%(n = 49)与髋关节有关,42%(n = 37)与膝关节有关,2%(2)与肩关节成形术有关。32%的病例分离出凝固酶阴性葡萄球菌(CoNS),23%分离出金黄色葡萄球菌(SA),9.0%分离出肠球菌和链球菌。19%的病例发生在手术后 3 个月内,17%发生在 3-12 个月内,64%发生在 12 个月后。不同研究发现的微生物组存在差异:本研究描述了与可比研究结果截然不同的局部 PJI 微生物群。已经制定了经验性抗生素指南以确定治疗目标,并建立了本地 PJI 登记册,以在抗生素耐药性时代改善患者预后和抗菌药物管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microbiologic features of prosthetic joint infections at a tertiary referral orthopaedic unit.

Background: Prosthetic joint infections (PJI) are a potential devasting consequence of arthroplasty surgery. Knowledge of the causative organism and antimicrobial sensitivity increases eradication success rates for PJI.

Aims: This study aimed to: 1) Observe the PJI microbiome at a tertiary referral arthroplasty unit; 2) Make comparison to similar published observations; and; 3) Establish empiric local antibiotic PJI guidelines.

Methods: All patients with positive tissue cultures for PJIs over a 4 year period were included. An electronic microbiology laboratory database search was performed to identify isolated microorganisms, sensitivities and resistances. Time from index procedure to PJI onset was recorded. The identified PJI microbiome was compared to current literature.

Results: 86 patients involving 88 joints were included. 56% (n = 49) related to hip, 42% (n = 37) to knee and 2% (2) to shoulder arthroplasty procedures. Coagulase Negative Staphylococci (CoNS) were isolated in 32% of cases, Staphylococcus aureus (SA) in 23%, Enterococcus species and Streptococcus species in 9.0%. 19% of case occurred within 3 months of index surgery, 17% from 3-12 months and 64% after 12 months. The microbiome identified varied comparable studies.

Conclusion: This study describes a local PJI microbiome with contrasting results from comparable studies. Empiric antibiotic guidelines have been established to target treatment and a local PJI register has since been established to improve patient outcomes and antimicrobial stewardship in an era of antibiotic resistance.

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来源期刊
Irish Journal of Medical Science
Irish Journal of Medical Science 医学-医学:内科
CiteScore
3.70
自引率
4.80%
发文量
357
审稿时长
4-8 weeks
期刊介绍: The Irish Journal of Medical Science is the official organ of the Royal Academy of Medicine in Ireland. Established in 1832, this quarterly journal is a contribution to medical science and an ideal forum for the younger medical/scientific professional to enter world literature and an ideal launching platform now, as in the past, for many a young research worker. The primary role of both the Academy and IJMS is that of providing a forum for the exchange of scientific information and to promote academic discussion, so essential to scientific progress.
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