Incidence and predictors of surgical site infection after ORIF in calcaneus fractures, a retrospective cohort study

Wang, Hui; Pei, Honglei; Wang, He

doi:10.1186/s13018-018-1003-y

Cited by 47 publications

(45 citation statements)

References 31 publications

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“…Secondly, previous studies have mostly focused on a specific part. These parts have a high risk of postoperative infection, such as the tibia, ankle joint, and calcaneus [ 16 , 17 , 21 , 22 ]. Finally, due to the large number of variables in the clinical and microbial characteristics of the patients, we excluded medical records with missing data.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and microbiology of fracture-related infection: a multicenter study in Northeast China

Wang

Xiao

Zhang³

et al. 2021

J Orthop Surg Res

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Objective This study aimed to explore the epidemiological and microbiological characteristics of fracture-related infection (FRI), analyze the drug resistance characteristics of major pathogens, and provide timely and relatively complete clinical and microbiological data for antimicrobial treatment of FRI. Methods The clinical and microbiological data of patients with FRI from January 1, 2011, to December 31, 2020, were collected from three tertiary hospitals in Northeast China. The automatic microbial analysis system was used for strain identification and drug susceptibility testing, and the drug susceptibility results were determined in accordance with the latest Clinical and Laboratory Standards Institute (CLSI) criteria (as applicable each year). Results A total of 744 patients with FRI were enrolled. The incidence of FRI was about 1.5%, and 81.7% were male patients, with an average age of 48.98 ± 16.01 years. Open fractures accounted for 64.8%. Motor crush (32.8%) and falling (29.8%) were the main causes of injuries. The common sites of infection were the tibia and fibula (47.6%), femur (11.8%), foot (11.8%), and hand (11.6%). A total of 566 pathogenic bacteria were cultured in 378 patients with positive bacterial cultures, of which 53.0% were Gram-positive bacteria and 47.0% were Gram-negative bacteria. The most common pathogen at all sites of infection is Staphylococcus aureus. Staphylococcus aureus had a high resistance rate to penicillin (PEN), erythromycin (ERY), and clindamycin (CLI), exceeding 50%. Methicillin-resistant Staphylococcus aureus (MRSA) was more than 80% resistant to CLI and ERY. Conclusions The incidence of FRI in Northeast China was at a low level among major medical centers nationwide. Staphylococcus aureus was still the main pathogen causing bone infections, and the proportion of MRSA was lower than reported abroad, but we have observed an increase in the proportion of infections. Enterobacteriaceae have a higher resistance rate to third-generation cephalosporins and quinolones. For Enterobacteriaceae, other sensitive treatment drugs should be selected clinically.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and microbiology of fracture-related infection: a multicenter study in Northeast China

Wang

Xiao

Zhang³

et al. 2021

J Orthop Surg Res

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“…Surgical site infection (SSI) is an adverse complication of orthopedic surgery and can increase the risk of readmission [1,2]. Moreover, SSI often caused poor prognosis, decreased quality of life and the possibility of reoperation [3,4].…”

Section: Introductionmentioning

confidence: 99%

Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study

et al. 2020

BMC Infect Dis

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Background Surgical site infection (SSI) is a devastating complication of orthopedic surgery, related with increased morbidity and mortality. This study was performed with the aim to compare the SSI rate in human immunodeficiency virus HIV-positive patients, to identify other risk factors for SSI and to establish a nomogram model to predict the risk of SSI. Methods A total of 101 HIV-positive individuals following orthopedic surgery patients admitted to Beijing Ditan Hospital. Their characteristics were gathered. The univariate and multiple logistic regression analysis were performed to explore the risk factors of SSI. And the Nomogram prediction model was constructed and verified. Results The independent predictive factors of SSI included CD4 (Odds ratio [OR], 0.041; P = 0.040), erythrocyte sedimentation rate (ESR) (OR, 89.773; P = 0.030), and procalcitonin (PCT) (OR, 220.746; P = 0.006). The scoring nomogram model was as follows: Logit (SSI) = − 2.63589–0.00314*CD4 < 430.75 = 1) + 0.04695*(ESR < 17.46 = 1) + 2.93694*(PCT < 0.22 = 1). The area under the Receiver Operating Characteristic (ROC) curve was 0.946. The cutoff score was − 2.1026 with a sensitivity of 93.33% and a specificity of 84.88%. Conclusions CD4, ESR, PCT might affect the occurrence of SSI after orthopedic surgery. The nomogram model constructed in this study is helpful for predicting the probability of SSI.

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“…This has been con rmation in other studies. [24,35] In our study, vascular injury at the fracture site is also identi ed as an independent risk factor for SSIs. Damage to deep blood vessels also means more severe injuries.…”

Section: Risk Factorsmentioning

confidence: 57%

Microbiology Characteristics and Risk Factors of Surgical Site Infection in Limb Fractures: a Single-center Retrospective Study

Luo

Chen

Zhang

et al. 2021

Preprint

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Background: Limb fractures were becoming more common, and internal fixation increased the risk of surgical site infection. The purpose of this study was to identified risk factors for surgical site infection and the factors that affected the microbiological characteristics.Material and methods: Data from patients with limb fractures who received internal fixation between January 2010 and January 2020 were included. Univariate and multivariate logistic analyses were performed to determine independent risk factors.Results: A total of 4479 patients were identified and 187 (4.18%) patients developed surgical site infections (SSI). Staphylococcus aureus (25.1%) was the most common bacteria, followed by Coagulase negative Staphylococcus (18.8%) and Acinetobacter baumannii (12.0%). Multiple regression analysis revealed that low total protein (OR, 4.066; 95% CI, 1.217-13.583) and high white blood cell count (OR, 3.133; 95% CI, 1.291-7.605) were risk factors for gram-negative bacteria infection. Five risk factors were identified to be independently associated with the development of SSIs, including current smoking (OR, 2.923; 95% CI, 1.294-6.599), high-energy injury (OR, 2.816; 95% CI, 1.368-5.799), femoral fracture, tibia and fibula fracture, vascular injury at the fracture site (OR, 10.284; 95% CI, 2.506-42.199), skin contusin at the fracture site (OR, 3.348; 95% CI, 1.304-8.574), hypohemoglobin (OR, 2.991; 95% CI, 1.422-6.292).Conclusion: Preoperative preventative measures should be taken in patients at high risk to reduce the incidence of SSIs.

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Incidence and predictors of surgical site infection after ORIF in calcaneus fractures, a retrospective cohort study

Cited by 47 publications

References 31 publications

Epidemiology and microbiology of fracture-related infection: a multicenter study in Northeast China

Epidemiology and microbiology of fracture-related infection: a multicenter study in Northeast China

Nomogram prediction of surgical site infection of HIV-infected patients following orthopedic surgery: a retrospective study

Microbiology Characteristics and Risk Factors of Surgical Site Infection in Limb Fractures: a Single-center Retrospective Study

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