What is the Rate of Methicillin-resistant Staphylococcus aureus and Gram-negative Infections in Open Fractures?
What is the Rate of Methicillin-resistant Staphylococcus aureus and Gram-negative Infections in Open Fractures?
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DOI：
10.1007/s11999-013-2855-4
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发表时间：
2013-10-01
影响因子：
4.2
通讯作者：
Evans, Andrew R.
中科院分区：
文献类型：
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作者：
Chen, Antonia F.;Schreiber, Verena M.;Evans, Andrew R.
社区中耐甲氧西林金黄色葡萄球菌（MRSA）感染的报道不断增加，但尚不清楚开放性骨折感染中的感染微生物是否发生了变化，以及我们目前的抗生素预防方案是否因此过时。我们确定了开放性骨折后近期MRSA和革兰氏阴性菌感染的发生率。我们对2009年至2010年治疗的202处开放性骨折的189名患者进行了回顾性队列研究。随访后，使用疾病控制和预防中心的标准对患者的感染迹象进行评估。我们使用常规微生物学培养来确定微生物。最短随访时间为 3 个月（中位时间 47 个月；范围 3-108 个月）。在 202 例开放性骨折中，20 例（10%）出现感染。最常见的微生物是葡萄球菌，而 5 名感染者 (25%) 的 MRSA 呈阳性，11 名感染者 (55%) 培养出至少一种革兰氏阴性微生物。六例 (30%) 开放性骨折出现感染，并产生多种微生物。我们开放性骨折人群中MRSA感染的发生率为2.5%。开放性骨折后MRSA和革兰氏阴性菌感染的发生率很高，这可能表明当前的抗生素治疗方案需要改变。IV级，回顾性病例系列。有关证据级别的完整描述，请参阅作者指南。
There have been increasing reports of methicillin-resistant Staphylococcus aureus (MRSA) infections in the community, but it is unclear whether infectious organisms in open fracture infections have changed and if our current regimen of antibiotic prophylaxis is therefore obsolete.We determined the recent incidence of MRSA and Gram-negative organism infections after open fractures.We performed a retrospective cohort study on 189 patients with 202 open fractures treated from 2009 to 2010. During the followup, patients were evaluated for signs of infection using the Centers for Disease Control and Prevention criteria. We determined the organisms using routine microbiology culture. The minimum followup was 3 months (median, 47 months; range, 3-108 months).Of the 202 open fractures, 20 (10%) developed infections. The most common organism was Staphylococcus, whereas five (25%) of those infected were positive for MRSA, and 11 (55%) of those with infection were cultured for at least one Gram-negative organism. Six (30%) open fractures had infections that grew out multiple organisms. The incidence of MRSA infections in our open fracture population was 2.5%.There is a high incidence of MRSA and Gram-negative infections after open fractures, which may indicate that current antibiotic regimens need to be changed.Level IV, retrospective case-series. See the Guidelines for Authors for a complete description of levels of evidence.