Analysis of clinical and etiologic features of patients with type Ⅰ incision surgical site infection in orthopedics department / 中华传染病杂志

ABSTRACT

Objective To explore the types and drug resistance of pathogens in patients with type Ⅰ incision surgical site infection in orthopedics department.Methods Patients with type Ⅰ incision surgical site infection in orthopedics department at Peking University Third Hospital from January 2005 to December 2013 were retrospectively collected.Clinical characteristics of patients,distribution and drug resistance of pathogens were analyzed.Results A total of 58.2 thousands patients with type Ⅰ incision surgical site were hospitalized from January 2005 to December 2013 in orthopedics department,and among them 442 patients had infection in the type Ⅰ incision surgical site.The infection rate was 0.8％.Infection was mainly observed in elderly patients.The most common diseases were lumbar canal stenosis (21.7％),cervical spondylosis (20.6％) and lumbar intervertebral disc herniation (14.0％).A total of 453 pathogenic strains were detected,of which 52.9％ were gram-positive bacteria,45.5％ were gramnegative bacteria and 1.6 ％ were fungi.The common pathogens were Staphylococcus aureus (25.2 ％),Staphylococcus epidermidis (14.1 ％),Escherichia coli (11.5 ％),Enterobacter cloacae (7.3 ％),Pseudomonas aeruginosa (6.2 ％) and Acinetobacter baumannii (6.0 ％).The percentage of Meticillinresistant Staphylococcus aureus (MRSA) was 23.7％ and the percentage of Meticillin-resistant Staphylococcus epidermidis (MRSE) was 43.8％.Vancomycin or linezolid-resistant Staphylococcus aureus or Staphylococcus epidermidis were not detected.Proportion of extended-spectrum beta-lactamases (ESBL) producing strains in Escherichia coli was 53.8％,and proportion of ESBL-producing strains in Klebesiella pneumonia was 50.0％.The resistance rates to impenem and meropenem of the three different species in Enterobacteriaceae,including Escherichia coli,Enterobacter cloacae and Klebsiella pneumonia,were 0.Resistance rates of Pseudomonas aeruginosa to cefoperazone-sulbactam,piperacillin-tazobactam were less than 10 ％.Resistance rate of Acinetobacter baumannii to minocyline was 11.1％ and resistance rates of it to other drugs were more than 20％.Conclusions The rate of type Ⅰ incision surgical site infection in orthopedics department is low.Gram-positive and gram-negative bacteria each account for half of the pathogens.The proportion of resistant pathogens is high and empirical treatment is needed to cover these pathogens.