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| Distribution of Pathogenic Bacteria, Drug Resistance and Factors Influencing Postoperative Infection in Patients with Osteoarthritis of the Knee Joint |
| CHAI Jing, WANG Doudou, WANG Jiao, et al |
| Shijiazhuang Third Hospital, Hebei Shijiazhuang 050000, China |
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Abstract Objective: To investigate the distribution of pathogenic bacteria, drug resistance and influencing factors of postoperative pseudojoint infection in patients with knee osteoarthritis in Shijiazhuang Third Hospital from 2016 to 2020. Methods: Totally 1509 patients with knee osteoarthritis who underwent knee surgery in Shijiazhuang Third Hospital from January 2016 to January 2020 were selected and divided into infection group (38 cases) and non-infection group (1471 cases) according to postoperative infection. The knee joint effusion of the infected patients was collected and cultured to detect the types of pathogenic bacteria and drug resistance. Clinical data were collected and multivariate Logistic regression was used to analyze the factors influencing postoperative infection in patients with knee osteoarthritis. Results: A total of 46 strains of pathogenic bacteria were detected, of which 86.96% were Gram-positive bacteria, Gram-positive bacteria were resistant to β-lactam, quinolones and other antibiotics.Duration of operation ≥3h, type 2 diabetes, rheumatoid arthritis, smoking, postoperative urinary tract infection and prevention without antibiotics were risk factors for postoperative periprosthetic infection in patients with knee osteoarthritis (P<0.05). Conclusion: Gram-positive bacteria are the main pathogenic bacteria of pseudojoint infection after knee osteoarthritis, and have high drug resistance rate. Long operation time, type 2 diabetes mellitus, rheumatoid arthritis, smoking, postoperative urinary tract infection and failure to use antibiotics to prevent infection are the main factors leading to infection around pseudarthrosis. Infection monitoring of high-risk patients should be strengthened and antibiotics should be rationally used to reduce the risk of infection.
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[1] Katz JN,Arant KR,Loeser RF.Diagnosis and treatment of hip and knee osteoarthritis:a review[J].JAMA,2021,325(6):568-578.
[2] Price AJ,Alvand A,Troelsen A,et al.Knee replacement[J].Lancet,2018,392(10158):1672-1682.
[3] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].北京:人 民军医出版社,2008.1337.
[4] Parvizi J,Zmistowski B,Berbari EF,et al.New definition for periprosthetic joint infection:from the Workgroup of the Musculoskeletal Infection Society[J].Clin Orthop Relat Res,2011,469(11):2992-2994.
[5] 孙哲,孙朝军,李红,等.初次人工全膝关节置换术后假体周围感染的危险因素分析[J].中国感染与化疗杂志,2021,21(5):546-551.
[6] 黄小敬,杨胜武,袁健东.髋膝关节置换术后假体周围感染的危险因素分析[J].中华医院感染学杂志,2014,24(6):1471-1473.
[7] 陈志,林佳俊,刘文革,等.髋膝关节置换术后假体周围感染病原菌分布与耐药性变化趋势分析[J].中国骨伤,2020,33(11):1032-1036.
[8] 张莉敏,杜建龙,沈娟丽.术中温度管理对老年髋部手术后手术部位感染的影响[J].浙江医学,2014,36(18):1558-1560.
[9] Kong L,Cao J,Zhang Y,et al.Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty:a meta-analysis[J].Int Wound,2017,14(3):529-536.
[10] Schmitt DR,Schneider AM,Brown NM.Impact of perioperative urinary tract Infection on surgical site infection in patients undergoing primary hip and knee arthroplasty[J].Arthroplasty,2020,35(10):2977-2982. |
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2023, Vol. 29 
