Clinical Analysis Of The Cause Of Chronic Infection After Hip Arthroplasty

Objective:To summary the type and number of Pathogens and their antibiotic sensitivity in articular surgery of Shandong Provincial Hospital with chronic infection after hip arthroplasty in order to offer information for treatment,for the purpose of Providing guidance and basis for clinical rational use of antibiotics, to develop reasonable treatment plan. For the risk factor of chronic infection in hip arthroplasty are summarized analysis, clear trigger THAthe risk factor of postoperative chronic infectionMethod:We performed a retrospective analysis of 95 patients that specimens were obtained at the time of a reoperation following a total hip/knee arthroplasty at our institutions since Jan 2010 to Jan 2014. Patient demographic data, bacterial species and the antibiotic sensitivity profile were recorded. A retrospective case-control study to analyze the risk factors of the infected arthroplasty from the infected patients(40 eases) which were performed operation in our hospital from January 2010 to January 2014, and 140 non-infected patients randomly selected as the control group. The χ2 test was used for statistical significance.Results:The ratio of positive culture was 91.58%, and the Gram-positive bacteria accounted for 75.51%, Gram-negative bacteria 23.47%, fungi accounted for 1.02%. The ratio of resistance was 68.49% in cephalosporins, and Staphylococcus methicillin-resistant Staphylococcus aureus rate was 73.02%. Bone tumors, revision surgery, fracture surgery, surgery duration>2h, postoperative drainage time>48h and wound complications were the risk factors for infection after arthroplasty. Gender, age, obesity, diabetes had no significant effect on chronic infection.Conclusion:The late prosthetic joint infections were mainly cased by Gram positive baeteria. A higher proportion of resistant strains were detected, pharmacotherapy should guided by the susceptibility results. Second generation cephalosporins were not suitable for prevent infection in patients who has risk factors of infection, and vancomycin plays an important role in the prevention and treatment of infection, which can be used as first-line drug. Bone tumors, revision surgery, fracture surgery, surgery duration>2h, postoperative drainage time>48h and wound complications were the risk factors for infection after arthroplasty. Factors such as age, obesity, diabetes, although is not significant, the increased incidence of infection clinically still need to be cautious.