急性、迟发性、慢性假体周围感染的病原学特征及疗效分析

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Abstract Objective To analyze the microbiology and antibiotic susceptibility of bacteria isolated from infected hip and knee joint，compareorganism profile and antibiotic susceptibilitybetween the acute，delayed and late infection patientsand to assess the antibiotic and surgery treatment outcome of prosthetic joint infection. Methods The microbiology and antimicrobial susceptibility data of prosthetic hip and knee infection patients between January 1，2010 and December 31，2015 were retrospective reviewed and analyzed.A total of 146 patients were identified.111 cases were prosthetic hip infection and 35 cases were prosthetic knee infection，with a mean age of (57.37±14.74)(range，29~89 ).The patients were divided into the acute，delayed and late infection groups.There were 19 cases in the acute group，20 cases in the delayed group and 107 in the lateinfection group.The organism profile，antibiotic susceptibility and treatment outcome were compared.Results Gram-positive bacteria wasthe main pathogen，whichwas found in 57.89% cases of the acute group，60.00% of the delayed group and 54.21%of thelate infection group.The most common organisms were Staphylococcus Epidermidis and Staphylococcus Aureus.The infections caused by Gram-negative bacteria were mainly enterobacter cloacae，pseudomonas aereginasa and escherichia coli.The results of antibiotic susceptibility showed bacteria were sensitive to antibiotic such as rifampin，linezolid，furantoin，quinupristin and vancomycin，but Gentamicin，tobramycin and cephalosporins had high resistance rate.And，with the increase of the infection time，the resistance of pathogen increased gradually.Two-stage revision was the most common surgical approach，encountered 89.72%，followed by irrigation and debridement (5.48%) and one-stage revision (4.79%).Conclusion The pathogen spectrum of prosthetic joint infectionis wide and complex，the dominate pathogen is Gram-positive bacteria，and the most common organisms is Staphylococcus.The antibiotic resistance rate is high，and with the increase of the infection time，the resistance rate increased gradually.So the antibiotic treatment and surgical approach should be individually and fully evaluated.

Key words： arthroplaty prosthetic related infection drug resistance antibiotic

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