Drug resistance of pathogenic bacteria and independent risk factors of deep incision infection in elderly patients after lumbar fracture surgery
Objective To analyze the pathogenic bacteria characteristics and drug resistance of deep incision infection after operation of lumbar spine fracture in elderly patients,and explore the risk factors of infection.Methods A total of 996 elderly patients with lumbar spine fracture who were treated with internal fixation in our hospital from April 2019 to March 2024 were selected as the study objects.According to whether deep incision infection occurred after surgery,they were divided into infected group(n=46)and non-infected group(n=950).Bacteria isolation culture and drug sensitivity test were performed on infected group.Logistic regression was used to analyze the risk factors of postoperative deep incision infection in patients with lumbar fracture.Results 55 strains of pathogenic bacteria were isolated from 46 patients with deep incision infection after lumbar fracture surgery,including 22 gram-positive bacteria,32 gram-negative bacteria and 1 fungus.The drug susceptibility results showed that the resistance rates of S.aureus to penicillin,amoxicillin and cefazolin were 90.91％,63.64％and 54.55％.The resistance rates of S.epidermidis to penicillin,amoxicillin and azithromycin were 75.00％,62.50％and 37.50％,.The resistance rates of E.coli to piperacillin,cefzolin and ceftazidime were 92.31％,61.54％and 61.54％.The resistance rates of P.aeruginosa to cefzolin,compound sulfamethoxazole and ceftriaxone were 90.00％,80.00％and 60.00％.There were no significant differences in gender,BMI,smoking history,drinking history,hypertension,anesthesia method,time from injury to operation,and intraoperative blood loss between the infected and non-infected groups(P＞0.05).There were significant differences in age,diabetes mellitus,number of operative stages,operative time,retention time of postoperative drainage tube,prophylactic use of antibiotics,and length of hospital stay(P＜0.05).Analysis in Logistic regression model,Results Age＞65 years old(OR=2.223,95％C.I.1.165-4.243),diabetes mellitus(OR=2.289,95％C.I.1.195-4.383),number of surgical segments＞3(OR=1.922,95％C.I.1.044-3.539),operation time＞2 hours(OR=2.101,95％C.I.1.101-4.010),postoperative drainage catheter retention time＞5 days(OR=2.247,95％C.I.1.199-4.210),prophylactic antibiotic use(OR=2.276,95％C.I.1.191-4.349),hospital stay＞14 days(OR=2.041,95％C.I.1.101-3.785 was the risk factor for postoperative deep incision infection in patients with lumbar fracture(P＜0.05).Conclusion E.coli,P.aeruginosa,S.aureus and S.epidermidis were common in elderly patients with lumbar fracture after operation,and had high resistance to piperacillin,cefazolin and penicillin.Factors such as age,diabetes,number of surgical segments,operation time,postoperative drainage catheter retention time,prophylactic use of antibiotics,length of hospital stay,etc.may have adverse effects on postoperative deep incision infection in patients,and should be paid attention to clinically.
aged lumbar spine fracturedeep incision infectioncharacteristics of pathogenic bacteriadrug resistance
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