CLINICAL AND MICROBIAL FEATURES OF PROSTHETIC JOINT INFECTION
CLINICAL AND MICROBIAL FEATURES OF PROSTHETIC JOINT INFECTION
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DOI：
10.1016/0002-9343(84)90434-0
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发表时间：
1984-01-01
影响因子：
5.9
通讯作者：
CHRISTIAN, CL
中科院分区：
文献类型：
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作者：
INMAN, RD;GALLEGOS, KV;CHRISTIAN, CL
对 1 年假体关节感染的经验进行了回顾，其中发现了 63 例病例。 30 例（48%）为早期感染，发生在术后第一年；33 例（52%）为晚期感染，发生在植入后 > 1 年。疼痛是主要症状，但提示感染的临床线索常常不存在，43% 的患者出现发烧，只有 10% 的患者出现白细胞增多。晚期感染的影像学表现更常见异常（67% vs. 37%，P < 0.02）。葡萄球菌是主要微生物，占假体关节感染的 59%，表皮葡萄球菌是早期和晚期感染的主要菌种。血行感染中，13例中有11例发生在晚期感染组；这些大多是非葡萄球菌。通过凝胶电泳对表皮葡萄球菌的抗原蛋白进行了表征，但当将患者血清与正常样本进行比较时，无法鉴定出感染特异性抗原。 50%的表皮葡萄球菌假体关节感染患者、27%的非葡萄球菌感染患者、20%的金黄色葡萄球菌感染患者和11%的正常受试者中存在针对表皮葡萄球菌细胞外蛋白的沉淀抗体。鉴于假体关节感染的重要性日益增加，有必要进一步研究感染的发病机制和宿主免疫反应。
A 1-yr experience with prosthetic joint infection, in which 63 cases were identified, was reviewed. Thirty cases (48%) were early infections, in the 1st postoperative yr and 33 cases (52%) were late, occurring > 1 yr after implantation. Pain was the predominant symptom, but clinical clues suggesting infection were frequently absent, with fever in 43% and leukocytosis in only 10%. The radiographic appearance was more frequently abnormal in late infections (67 vs. 37%, P < 0.02). Staphylococci were predominant organisms, constituting 59% of prosthetic joint infections and Staphylococcus epidermidis was the predominant species in both early and later infections. Of the hematogenous infections, 11 of 13 occurred in the group with late infections; these were mostly nonstaphylococcal. Antigenic proteins of S. epidermidis were characterized by gel electrophoresis, but no infection-specific antigens could be identified when patient serum was compared with normal samples. Precipitating antibodies to the extracellular proteins of S. epidermidis were present in 50% of patients with S. epidermidis prosthetic joint infections, 27% of patients with nonstaphylococcal infections, 20% of patients with S. aureus infections and 11% of normal subjects. In view of the increasing importance of prosthetic joint infection, further study of the pathogenesis of the infection and the host immune response is warranted.