Epidemiology and Drug Resistance Analysis of Mixed Infection in Orthopedic Surgical Sites

Abstract

Background: Infection, including mixed infection, is not uncommon in orthopedic surgical incision. This study aimed to investigate the epidemiology and drug resistance of mixed infections after orthopedic surgical procedures. Methods: We retrospectively analyzed 533 orthopedic surgical site infections (SSIs) in a university hospital from 2012 to 2017. Eighty-six patients (218 strains) with bacterial culture results showing more than one strain were screened to explore their epidemiology and drug resistance. Results: Of 218 bacterial strains, 2-7 bacterial infections were noted in each wound. Most infections were caused by two kinds of bacteria (65.1%). The number of infections decreased with increased number of strains. The combinations of pathogenic microorganisms were all gram-negative, 55.81%; gram-positive and gramnegative, 30.23%; all gram-positive, 12.79%; and gram-positive and fungi, 1.16%. Their resistance is consistent with the bacterial resistance of 447 cases of single bacterial SSI during the same period. Hospitalization duration was longer (9.8-20.6 d). Conclusion: Our study shows no significant changes in epidemiology and drug resistance caused by mixed infections in the orthopedic surgical site because of coordination and competition among microorganisms. These bacteria are difficult to control, leading to extended hospitalization. Antibiotic agents should be chosen strictly according to drug sensitivity, and ineffective antibiotic agents must be avoided.

Microbiological Profile and Drug Resistance Analysis of Postoperative Infections following Orthopedic Surgery: A 5-Year Retrospective Review

“…Xie et al reported that S . aureus had high resistance to penicillin and ampicillin 97.89% and 100%, respectively, which is in line with our findings [ 28 ]. However, the oxacillin resistance rate in our study is higher than that of other studies.…”

“…Regarding S. aureus, our results showed high resistance to oxacillin, ampicillin, benzylpenicillin, and amoxicillin/ clavulanic acid 77.4%, 91.7%, 96.9%, and 100%, respectively. Xie et al reported that S. aureus had high resistance to penicillin and ampicillin 97.89% and 100%, respectively, which is in line with our findings [28]. However, the oxacillin resistance rate in our study is higher than that of other studies.…”

“…However, the oxacillin resistance rate in our study is higher than that of other studies. Hassan et al found a rate of 53.3%, and in another study, it was 52.4% [ 28 , 29 ]. In the light of these findings, an effective intervention must be implemented as the high resistance rates to those common antibiotics will be reflected in the treatment efficacy sooner or later.…”

Analysis of clinical characteristics, pathogen infection, and drug sensitivity of Marine injury patients: A cross-sectional study

“…The distribution of pathogenic bacteria is different from that of bacteria infected with trauma. [ 5 , 6 ] It can be seen from the drug sensitivity that Gram-negative are sensitive to aminoglycosides, lactam antibiotics, carbapenems antibiotics sulfonamides quinolones, fourth-generation cephalosporins, and antibacterial drugs containing enzyme inhibitors, while most bacteria are resistant to first-generation cephalosporins and second-generation penicillin antibiotics. Multiple resistance mechanisms have been demonstrated, including antibiotic degradation, antibiotic target modification, and regulation of permeability through bacterial membranes.…”

Connections between Orthopedic Conditions and Oxidative Stress: Current Perspective and the Possible Relevance of Other Factors, Such as Metabolic Implications, Antibiotic Resistance, and COVID-19

“…Incision infections can be determined by several risk factors, such as local soft tissue injury, surgical bleeding, and long operation duration, and they are still the most common complication after surgery. Most of the times, the infections are mixed, caused by two or more pathogens, with the most common ones being S. aureus and Pseudomonas aeruginosa in the wounds of patients with extensive burns or complex conditions [ 96 , 97 ].…”