摘要
目的了解骨关节感染患者感染指标变化与感染病原菌检测结果,为预防骨关节感染的临床诊治提供参考。方法选取2017年1月~2018年6月在宁波市第六医院诊治的骨关节感染患者(感染组)患者100例,选取同期门诊体检正常者50例为对照(对照组),检测血清降钙素原(PCT)、高敏C反应蛋白(hs-CRP)及血沉(ESR),采集患者感染部位样本进行病原菌培养。结果感染组患者血清PCT、hs-CRP及ESR分别为(1.03±0.15)μg/L、(28.94±8.05)mg/L、(32.39±5.20)mm/h,高于对照组(0.05±0.02)μg/L、(3.21±2.17)mg/L、(9.45±4.13)mm/h,差异有统计学意义(P<0.05);感染组中81例患者采集的病变部位样本培养出病原菌,培养阳性率为81.00%,其中75例为单一病原菌感染、6例为双重病原菌感染,分别占92.59%、7.41%。共培养出病原菌87株,其中革兰阴性菌45株、革兰阳性菌40株、真菌2株,分别占51.72%、45.98%、2.30%;感染主要病原菌为铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、表皮葡萄球菌,分别占16.09%、12.64%、11.49%、9.20%。结论骨关节感染患者可出现血清PCT、hs-CRP等感染指标的升高,感染病原菌主要以铜绿假单胞菌、金黄色葡萄球菌等为主,以单一病原菌感染多见。
Objective To understand the changes of infection index and distributions of pathogens in patients with osteoarticular infection,and to provide reference for clinical diagnosis and treatment of osteoarticular infection.Methods 100 patients with osteoarticular infection treated in Ningbo Sixth Hospital from January 2017 to June 2018 and 50 healthy controls were enrolled.Serum procalcitonin(PCT),hypersensitive c-reactive protein(hs-CRP)and erythrocyte sedimentation rate(ESR)were detected,pathogenic bacteria culture was performed on the samples of the infected lesions.Results The serum levels of PCT and hs-CRP and PCT were higher in patients than in controls(1.03±0.15 vs 0.05±0.02μg/L;28.94±8.05 vs 3.21±2.17 mg/L;32.39±5.20 vs 9.45±4.13 mm/h),the differences were statistically significant(P<0.05).81 cases were pathogen-culture positive with the positive rate of 81.00%,92.59%were single pathogenic bacteria infection and 7.41%cases were two bacteria co-infection.Total 87 strains of pathogens were identified,including 45 strains of gram-negative bacteria(51.72%),40 strains of gram-positive bacteria(45.98%)and 2 strains of fungi(2.30%).The major pathogenic bacteria were pseudomonas aeruginosa,staphylococcus aureus,escherichia coli and staphylococcus epidermidis,accounting for 16.09%,12.64%,11.49%and 9.20%of total infections,respectively.Conclusions The increased serum levels of PCT,hs-crp and other infection indices can be noticed in patients with osteoarticular infection,and pseudomonas aeruginosa and staphylococcus aureus are predominant pathogens,and most infections are caused by one pathogen.
作者
余慧
刘亚珍
潘兰玲
范华婕
吴俊
王巧珍
YU-Hui;LIU Ya-zhen;PAN Lan-ling;FAN Hua-jie;WU Jun;WANG Qiao-zhen(Department of Orthopedics,Ningbo Sixth Hospital,Ningbo,Zhejiang,315800,China)
出处
《中国预防医学杂志》
CAS
CSCD
2019年第5期422-425,共4页
Chinese Preventive Medicine
基金
浙江省基础公益研究计划项目,项目编号:LY18H060008
关键词
骨关节
感染
降钙素原
高敏C反应蛋白
血沉
病原菌
细菌培养
Osteoarticular infection
Procalcitonin
Hypersensitive c-reactive protein
Erythrocyte sedimentation
Pathogenic bacteria
Bacterial culture
