Infectious pathogenic bacteria after internal fixation in patients with limb fractures and Smad pathway and bone metabolism index levels
OBJECTIVE To analyze the infectious pathogenic bacteria after internal fixation of limb fracture,and Smad pathway and changes of bone metabolism indexes levels.METHODS The clinical data of 985 patients with limb fractures treated in Huzhou First People's Hospital from Jan.,2020 to Dec.,2022 were retrospectively ana-lyzed.Patients were divided into the postoperative infection group(27 cases)and the postoperative non-infection group(958 cases)according to whether postoperative infection occurred or not.The drug resistance and clinical characteristics of pathogenic bacteria in postoperative infection group were counted.Levels of Smad pathway and bone metabolism indexes were compared between the postoperative infection group and the postoperative non-in-fection group.RESULTS A total of 34 strains of pathogenic bacteria were isolated from 27 patients with infection after internal fixation of limb fractures,of which 21 strains of gram-positive bacteria accounted for 61.76％,12 strains of gram-negative bacteria accounted for 35.29％,and 1 strain of fungus accounted for 2.94％,mainly Staphylococcus aureus,Staphylococcus epidermidis and Escherichia coli.Staphylococcus aureus were resistant to erythromycin,penicillin,oxacillin,and ampicillin,while sensitive to amikacin,minocycline,and rifampicin.Escherichia coli was highly resistant to cefuroxime,cefradine,cefotaxime,minocycline,and ampicillin/sulbac-tam,while sensitive to imipenem and amikacin.The Smad 1,Smad 2 and Smad 3 proteins in peripheral blood mononuclear cells in the postoperative infection group were higher than those in the postoperative non-infection group,while serum calcitonin(CT),osteocalcin(OC),bone alkaline phosphatase(BALP),procollagen Ⅰ ami-no-terminal peptide(P Ⅰ NP),bone γ-hydroxyglutamate(BGP)and bone morphogenetic protein-2(BMP-2)were lower than those in the postoperative non-infection group(P＜0.05).CONCLUSION The infectious pathogens af-ter internal fixation of limb fractures were mainly gram-positive bacteria,which could activate Smad pathway and reduce the level of bone metabolism,which was not conducive to fracture healing and recovery,and its occurrence was related to the underlying diseases,fracture types and treatment conditions,while there were differences in the drug resistance of its main pathogens.
Fracture of limbsInternal fixationPostoperaqive infectionPathogenSmad pathwayBone metabo-lism
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