Abstract
Objective To study the distribution and risk factors of multidrug-resistant bacteria (MDROS) infection in orthopedic patients and to provide reference for clinical prevention and control measures. Methods The data of 239 inpatients with orthopedic trauma from June 2019 to December 2020 were selected as the research objects, and the distribution characteristics of MDROS infection were analyzed through the real-time monitoring system of nosocomial infection. Logistic regression analysis was used to screen out the risk factors causing MDROS infection, and the preventive measures were put forward. Results 178 strains of pathogens were isolated from 239 patients, including 53 strains of MDROS, and the detection rate was 29.78%. The main pathogenic bacteria were ESBLs, MRSA, CRAB, CRE, and MDR/PDRPA. The main infection sites of MDROS in orthopedic patients were the respiratory tract and wound. No CRE1 was detected, and 64.39%, 17.42%, and 14.39% of ESBL-producing bacteria, MRSA, and MDR/PDRPA, respectively, were detected. Logistic multivariate analysis showed that the length of hospital stay, antibiotic use time, open injury, and serum albumin level were independent risk factors of MDROS infection in orthopedic trauma patients. Conclusion To prevent MDROS infection in orthopedic patients, we should start from many aspects, focusing on reducing unnecessary hospitalization days, rationally preventing the use of antibacterial drugs, effectively treating basic diseases, etc., timely and effective thorough debridement, strengthening functional training, reducing bed rest, and strengthening targeted monitoring of related infections which are the keys to reduce MDROS infection in orthopedic patients.
Highlights
Multidrug-resistant bacteria refer to pathogenic bacteria with multidrug resistance, and it has drug resistance to a variety of drugs. ey are defined as microorganisms against three categories or more than three kinds of antibiotics with different mechanisms which are resistant at the same time, rather than three kinds of the same kind
In order to effectively reduce the incidence of MDROS in open wounds in orthopedics, this study reviewed the risk factors of MDROS infection in open wounds in orthopedics and provided reference for preventing MDROS infection in open wounds in orthopedics
Univariate Analysis of Risk Factors for MDROS Infection. 178 strains of pathogens were isolated from 239 patients, including 53 strains of MDROS, and the detection rate was 29.78%. e main pathogenic bacteria were ESBLs, methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Enterobacteriaceae (CRE), and multidrug-resistant/pan drugresistant Pseudomonas aeruginosa (MDR)/PDRPA. e main risk factors were the patient’s age, hospital stay, operation time, antibiotic use time and glucocorticoid use, complicated diabetes, open injury, mechanical ventilation, serum albumin, and indwelling catheterization. e differences were statistically significant within the same group (P < 0.05)
Summary
Multidrug-resistant bacteria refer to pathogenic bacteria with multidrug resistance, and it has drug resistance to a variety of drugs. ey are defined as microorganisms against three categories (such as aminoglycosides, macrolides, and β-lactams) or more than three kinds of antibiotics with different mechanisms which are resistant at the same time, rather than three kinds of the same kind. Multidrug-resistant bacteria (MDROS) are a kind of pathogenic bacteria which are resistant to three or more antibiotics at the same time. With the increasing drug resistance of pathogenic bacteria, MDROS has gradually become an important pathogen of open wound infection in orthopedics, which increases the difficulty of using antibiotics to treat open wound infection in orthopedics, and has become a thorny clinical problem [1, 2]. Monitoring and analyzing the distribution characteristics and risk factors of MDROS in orthopedic patients can provide reference for the prevention and treatment of MDROS infection in orthopedic patients [3]. In order to effectively reduce the incidence of MDROS in open wounds in orthopedics, this study reviewed the risk factors of MDROS infection in open wounds in orthopedics and provided reference for preventing MDROS infection in open wounds in orthopedics
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