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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
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创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
老年PJI慢性细菌感染特点分析
Analysis of the characteristics of PJI with chronic bacterial infection in elderly
投稿时间:2018-11-18  修订日期:2018-12-24
DOI:
中文关键词:  PJI;老年患者;慢性感染;细菌谱;耐药特点
英文关键词:
基金项目:基金项目:广州市科技计划基金资助项目(2014KP000075)
作者单位E-mail
陈祥 广州市第一人民医院关节外科 windsdaychen@sina.com 
摘要点击次数: 37
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中文摘要:
      摘要:目的 探讨老年PJI慢性细菌感染的高危因素、细菌谱、细菌耐药特点及其与急性感染的区别,为临床防治老年PJI慢性细菌感染提供参考。方法 回顾性分析广州市第一人民医院关节外科2013年1月-2018年10月收治的76例初次和翻修人工髋膝关节置换术后老年慢性感染患者资料,对基本资料、感染细菌谱及其耐药特点进行统计分析。结果 76例患者中,糖尿病患者40人,术前贫血56人,低蛋白44人,肥胖患者10人;共分离培养出细菌108株,其中革兰阳性菌占72.22%,主要为金黄色葡萄球菌与表皮葡萄球菌,不同细菌对抗生素耐药情况有差异。老年慢性感染细菌谱与急性感染相比,金黄色葡萄球菌占比下降,大肠杆菌占比接近;65岁及以上患者与年轻患者相比,金黄色葡萄球菌占比相对降低,革兰阴性杆菌占比相对升高。结论 糖尿病、贫血、低蛋白、肥胖为老年PJI慢性细菌感染高危因素;其主要致病菌为金黄色葡萄球菌;慢性感染细菌谱与急性感染不同,应根据药敏实验合理选用抗生素,提高临床疗效。
英文摘要:
      Abstract:OBJECTIVE To explore the risk factors, bacterial spectrum, characteristics of bacterial resistance of PJI with chronic bacterial infection in elderly patients, and the differences with acute infection.For the purpose of providing references for clinical prevention and treatment of PJI with chronic bacterial infection in elderly patients.METHODS The clinical data of 76 patients with chronic infections after initial and revision arthroplasty of hip and knee in Guangzhou No. 1 People's Hospital from Jan.2013 to Oct.2018 were retrospectively analyzed.The bacterial species and drug resistance were investigated .RESULTS Of the 76 patients, 40 had diabetes, 56 had preoperative anemia, 44 had low protein, and 10 had obesity.108 bacteria were isolated ,of which 72.22% were gram-positive bacteria, mainly staphylococcus aureus and staphylococcus epidermidis.Different bacteria have different resistance to antibiotics.Compared with acute infection,the proportion of staphylococcus aureus decreased and the proportion of escherichia coli was close.The proportion of staphylococcus aureus was lower and the proportion of gram-negative bacilli was higher in patients aged over 65.CONCLUSIONS Diabetes, anemia, low protein and obesity are the risk factors for chronic PJI with bacterial infection in the elderly.The main bacteria were staphylococcus aureus and staphylococcus epidermidis, differ from acute infection,and we should use antibiotics rationally according to drug sensitivity test to improve clinical efficacy.
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