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- Title
胫腓骨开放性骨折术后并发感染的病原菌分布、耐药性及影响因素分析.
- Authors
何杨; 张平方; 张辉; 赵宇宙; 王建民; 董红
- Abstract
Objective: To study the distribution,drug resistance and influencing factors of pathogen causing postoperative infection in open tibial and fibular fractures. Methods: The clinical data of 267 patients with open fracture of tibia and fibula who were treated in General Hospital of North China Petroleum Administration from January 2014 to January 2018 were retrospectively analyzed. Postoperative infection cases was counted, the distribution of pathogens causing postoperative infection in open tibial and fibular fracture was analyzed, and antimicrobial resistance of major gram-positive bacteria and major gram negative bacteria was analyzed. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of postoperative infection. Results: Among 267 patients, 68 cases had occurred postoperative infection, the infection rate was 25.47%. 82 strains of pathogen were isolated from 68 patients, of which gram positive bacteria was accounted for 64.63%, gram-negative bacteria was accounted for 28.05%, fungi was accounted for 7.32%.Staphylococcus aureus, staphylococcus epidermidis, and enterococcus faecalis were more resistant to penicillin, piperacillin/tazobactam,which were more sensitive to vancomycin and imipenem. Escherichia coli, enterobacter cloacae, pseudomonas aeruginosa and acinetobacter baumannii were more resistant to cefazolin, which were more sensitive to imipenem and cefoperazone/sulbactam. Univariate analysis showed that the causes of injury, fracture site, diabetes, injury to operation time, debridement, hemostasis, drainage, and no use of antibiotics were all related factors causing postoperative infection in open tibial and fibular fractures(P<0.05). Multivariate Logistic regression analysis showed that the injury to the operation time >6 h, incomplete debridement, incomplete hemostasis, obstructed drainage and postoperative no use of antibiotics were all risk factors causing postoperative infection in open tibial and fibular fractures(P<0.05).Conclusion: Postoperative infection of tibiofibula open fractures is mainly caused by Gram-positive bacteria, and their sensitivity to penicillin and piperacillin/tazobactam is lower. Clinically, effective preventive measures should be taken against risk factors, and effective drug therapy should be selected according to drug sensitivity test.
- Publication
Progress in Modern Biomedicine, 2019, Vol 19, Issue 9, p1743
- ISSN
1673-6273
- Publication type
Article
- DOI
10.13241/j.cnki.pmb.2019.09.031