Surgical site infection with methicillin-resistant Staphylococcus aureus after primary total hip replacement
Surgical site infection with methicillin-resistant Staphylococcus aureus after primary total hip replacement
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DOI：
10.1302/0301-620x.90b3.20155
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发表时间：
2008-03-01
影响因子：
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通讯作者：
McCabe, J. P.
中科院分区：
文献类型：
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作者：
Walls, R. J.;Roche, S. J.;McCabe, J. P.
我们分析了一系列连续患者的管理和临床结果，这些患者接受了全髋关节置换术，术后发生了耐甲氧西林金黄色葡萄球菌的手术部位感染（SSI）。这种感染的发生率在五年内为1%。我们研究了15例患者（16例感染）的SSI，平均年龄为72.7岁（53至81岁）。总的来说，12例感染发生在早期，一半的感染涉及假体，导致累积住院时间增加了11倍。平均随访53.6个月（25至88个月）后，所有患者的金黄色葡萄球菌均成功根除。浅表切口感染在单独抗生素治疗后消退，而深部感染需要多次手术清创。在早期器官间隙感染中，仅1/5例患者成功保留植入物。只有3例植入物水平感染的患者获得了无痛的功能性假体，而另外3例需要切除关节成形术。我们制定了一项治疗方案，可作为管理这些感染的指南。
We have analysed the management and clinical outcome of a series of consecutive patients who had a total hip replacement and developed post-operative surgical site infection (SSI) with methicillin-resistant Staphylococcus aureus. The incidence of this infection was 1% over a period of five years. We studied SSI in 15 patients (16 infections) with a mean age of 72.7 years (53 to 81). In all, 12 of the infections occurred early and half of the infections involved the prosthesis, resulting in an increase of 11-fold in the cumulative hospital stay.Methicillin-resistant Staph. aureus was successfully eradicated in all the patients after a mean follow-up of 53.6 months (25 to 88). Superficial incisional infections resolved after antibiotic therapy alone while deep infections required multiple operative debridements. Attempted retention of the implant in early organ space infections was successful in only one of five patients. Only three patients with implant-level infections obtained a pain-free, functional prosthesis while a further three required excision arthroplasty. We have formulated a protocol of treatment which may serve as a guide in the management of these infections.