Analysis Of Pathogenic Bacteria And Risk Factors Of Traumatic Limb Osteomyelitis

With the use of antibiotics,bacterial resistance in chronic osteomyelitis is becoming more and more serious.Detection of bacteria and detection of antibiotic sensitivity are very important for the treatment of chronic osteomyelitis and the application of clinical antibiotics.Chronic osteomyelitis is characterized by great difficulty in treatment,high recurrence rate and high cost.The aim of this study was to analyze the bacterial species and antibiotic sensitivity of patients with traumatic chronic osteomyelitis in Kaifeng,China,to provide reference for clinical use of antibiotics,and to analyze the risk factors of traumatic chronic osteomyelitis,to provide guidance for the prevention of chronic osteomyelitis after traumatic fracture.A retrospective analysis of the medical records of patients with traumatic limb fractures from January 2018 to January 2022 in four hospitals in Kaifeng was conducted,350 cases without osteomyelitis were matched by 1:1 condition according to age,sex,time of trauma(within 1 week)and site of infection.The types of bacterial infection and drug sensitivity of chronic osteomyelitis patients were analyzed statistically.The influencing factors of chronic osteomyelitis were analyzed by univariate chi-square and binary logistic regression.The results were as follows:(1)402 strains of bacteria were detected in 350 patients with chronic osteomyelitis,including 176 strains of Gram-positive bacteria(43.78%)and 226 strains of Gram-negative(56.22%)The main pathogens were Staphylococcus aureus(44.89%)Pseudomonas aeruginosa(29.20%)Enterobacter cloacae(26.55%)Escherichia coli(23.45%)and methicillin-resistant staphylococcus(15.91%)(2)Gram-positive bacteria drug sensitivity test: the resistance rate of Vancomycin,Linezolid,nitrofurantoin and Kauranen was 0,the resistance rate of penicillin G was 100%.The resistance rate of Staphylococcus epidermidis to penicillin G and oxacillin was 100%,and to rifampicin and tetracycline was 20%.The resistance rate of Staphylococcus aureus to Rifampicin was 5.06%.The resistance rate of methicillin-resistant staphylococcus was generally high.The resistance rate of erythromycin,oxacillin and penicillin G was 100%.The resistance rate of gentamicin,Levofloxacin and tetracycline was more than 80%.(3)the Gram-negative drug resistance rate of Pseudomonas aeruginosa,Enterobacter cloacae,Escherichia coli,Klebsiella pneumoniae and imipenem was 0.Resistance rates to other drugs such as Amikacin,piperacillin tazobactam,Tobramycin,ceftazidime and cefepime were lower than that of ampicillin,but higher than that of ampicillin.(4)Analysis of influencing factors of traumatic chronic osteomyelitis of limbs: chi square test analysis results showed that: diabetes,hypoproteinemia,anemia,operation time,bleeding volume,and body mass index(BMI)were statistically significant between the two groups(P<0.05).The results of multivariate analysis showed that diabetes(P<0.05),hypoproteinemia(P<0.05),anemia(P<0.05),operation time(P<0.05),blood loss(P<0.05),BMI(P<0.05)were independent risk factors for chronic osteomyelitis(P<0.05).Therefore,Staphylococcus aureus,Enterobacteriaceae cloacae,Escherichia coli and Pseudomonas aeruginosa are the main pathogens of traumatic chronic osteomyelitis.Diabetes,hypoproteinemia,anemia,operation time,amount of bleeding,BMI are independent risk factors of traumatic chronic osteomyelitis.