首页|贪婪皮肤杆菌致人工肩关节置换术后感染1例并文献复习

贪婪皮肤杆菌致人工肩关节置换术后感染1例并文献复习

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目的 探讨贪婪皮肤杆菌引起的人工关节假体周围感染(PJI)的临床特点及诊治方案。方法 总结1例贪婪皮肤杆菌引起的PJI患者的诊疗过程,检索数据库相关文献进行复习。结果 患者女性,65岁,身体质量指数(BMI)31。1 kg/m2,左肱骨近端骨折后行"左肱骨头假体置换术",术后10个月伤口愈合不良伴渗出,左肩关节活动受限,诊断为人工肩关节置换术后感染。行感染扩创病灶清除术及假体取出术,组织、骨水泥、假体均培养出贪婪皮肤杆菌。检索并筛选出4篇文献,共报道30例因贪婪皮肤杆菌引起PJI的患者(髋关节28例,肩关节2例),78。6%(22例)的人工髋关节假体(THA)手术采用直接前入路(DAA);术前关节液培养阳性率为71。4%,29例进行外科手术结合敏感抗菌药物治疗;除一例患者反复感染,行3次手术外,其他患者预后良好。结论 贪婪皮肤杆菌引起的PJI常见于肥胖且采用DAA的THA患者,少数病例也见于人工肩关节置换术后。术前受累关节穿刺微生物培养敏感性较高,可为手术策略与抗感染方案的制定提供重要依据。
Infection following shoulder arthroplasty caused by Cutibacterium avi-dum:a case report and literature review
Objective To explore the clinical characteristics and treatment scheme of periprosthetic joint infection(PJI)caused by Cutibacterium avidum(C.avidum).Methods The diagnosis and treatment process of a patient with PJI caused by C.avidum was summarized,and relevant literatures in the database were retrieved for review.Results A 65-year-old female patient with body mass index(BMI)of 31.1 kg/m2 underwent left humeral head prosthesis replacement surgery following a left proximal humerus fracture.Ten months after the surgery,the pa-tient exhibited poor wound healing and oozing,along with limited movement of the left shoulder joint,and was diag-nosed infection following shoulder arthroplasty.Patient underwent debridement of the infected lesion and removal of the prosthesis.The tissue,bone cement and prosthesis were cultured for C.avidum.Four literatures were re-trieved and screened,a total of 30 patients with PJI(28 cases hip joint infection and 2 cases shoulder joint infection)caused by C.avidum were reported through literature retrieval,and 78.6%(n=22)total hip arthroplasty(THA)surgeries were performed using direct anterior approach(DAA).The positive rate of preoperative joint fluid culture was 71.4%,29 cases underwent surgical combined with sensitive antimicrobials treatment.Except for one patient who had repeated infection and underwent three surgeries,other patients had a good prognosis.Conclusion PJI caused by C.avidum is mostly seen in THA patients who are obese and undergo DAA,with a few cases reported after shoulder arthroplasty.The high sensitivity of preoperative joint fluid culture provides an important basis for the development of surgical strategies and anti-infection protocols.

Cutibacterium avidumPropionibacterium avidumartificial joint infectionshoulder arthroplasty

郭庆昕、曾慧意、郭超龙、庄智勇、郭金花、蔡丽龙、李炳钻

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泉州市正骨医院检验科,福建 泉州 362000

泉州市正骨医院小儿骨科,福建 泉州 362000

泉州市正骨医院手外科,福建 泉州 362000

泉州市正骨医院关节科,福建 泉州 362000

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贪婪皮肤杆菌 贪婪丙酸杆菌 人工关节感染 肩关节置换术

泉州市科技局医疗卫生领域指导性科技计划项目

泉科2021-150号

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(2)
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