Objective: With the increasing volume of trauma surgery, postoperative infections have garnered significant attention, as they not only affect patient outcomes but also raise healthcare costs and the risk of bacterial resistance. This study aims to analyze the microbial spectrum and antibiotic sensitivity of patients with postoperative infections in trauma surgery, providing a basis for clinical treatment and optimizing antibiotic usage strategies in this context. Methods: A retrospective analysis was conducted on patients with traumatic infections who were hospitalized in the departments of spine surgery, upper limb surgery, and lower limb surgery from January 2022 to December 2024. Bacterial culture-positive specimens were analyzed for bacterial species and antibiotic sensitivity. Results: A total of 804 traumatic infection specimens were submitted for testing, including 538 male patients (ages 2 - 95 years) and 266 female patients (ages 4 - 94 years). Among these, 267 cases showed positive culture results, with 172 males (ages 2 - 93 years) and 95 females (ages 4 - 94 years). A total of 153 strains of Gram-negative (G？) bacteria and 114 strains of Gram-positive (G+) bacteria were identified. Among G？ bacteria, Escherichia coli was the most frequently isolated (40 strains), followed by Pseudomonas aeruginosa (28 strains) and Enterobacter cloacae (28 strains). Among G+ bacteria, Staphylococcus aureus was the most prevalent (75 strains), followed by Enterococcus faecalis (15 strains) and Streptococcus pyogenes (8 strains). Antibiotic sensitivity testing revealed that the resistance rate of Staphylococcus aureus to penicillin was as high as 93.33%, while the resistance rate of Escherichia coli to trimethoprim-sulfamethoxazole was 57.5%. Conclusion: The main pathogens responsible for postoperative infections in traumatology are Escherichia coli and Staphylococcus aureus, with significant antibiotic resistance. In clinical treatment, antibiotics should be selected rationally based on bacterial spectrum and resistance patterns to improve treatment efficacy.
References
[1]
Zhu, X.D. and Wang, W. (2021) Analysis of Clinical Characteristics and Influencing Factors of Traumatic Infections. Chinese Journal of Surgery, 59, 492-496.
[2]
Li, M. and Sun, H. (2022) The Impact of Antibiotic Resistance on the Treatment of Traumatic Infections. Chinese Journal of Hospital Infection, 32, 456-459.
[3]
Chen, W., Liang, J., Zhang, Q., et al. (2023) Pathogen Spectrum and Antibiotic Sensitivity Analysis of Traumatic Infections. Modern Medicine, 51, 78-82.
[4]
Wang, F., Zhang, Q., Li, H., et al. (2023) The Relationship between Antibiotic Use and the Development of Resistance. Chinese Journal of Antibiotics, 48, 233-237.
[5]
Deng, H., Zheng, M., Liu, W., et al. (2022) Comparative Study of Microbial Spectrum of Traumatic Infections in Different Regions. Chinese Journal of Clinical Medicine, 29, 1120-1125.
[6]
He, L., Zhou, Y., Zhao, Q., et al. (2023) Bacterial Resistance and Its Clinical Impact in Traumatic Infections. Chinese Journal of Surgery, 61, 324-328.
[7]
Liu, H. and Ma, Q. (2021) The Application of Standardized Bacterial Culture and Antibiotic Sensitivity Testing in Clinical Practice. Chinese Journal of Experimental Medicine, 41, 1184-1188.
[8]
Zhang, X. and Huang, L. (2022) Research Progress on Antibiotic Use Strategies for Traumatic Infections. Medicine and Pharmacy, 40, 590-596.
[9]
World Medical Association (2013) Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310, 2191-2194. https://doi.org/10.1001/jama.2013.281053
[10]
Zhang, W. and Li, M. (2023) Clinical Microbiology Laboratory Standard Operating Procedures. Chinese Medical Journal, 103, 927-932.
[11]
Chen, H. and Wang, F. (2023) Clinical Application and Resistance Analysis of Antibiotics. Chinese Journal of Antibiotics, 48, 233-237.
[12]
Liu, Q. and Zhao, M. (2022) Clinical Characteristics and Related Factors of Traumatic Infections. Modern Medicine, 51, 78-82.
[13]
Smith, J., Brown, A., Green, T., et al. (2020) Pathogens in Surgical Infections: A Review of Current Literature. Journal of Surgical Research, 15, 123-130.
[14]
Zhang, L., Wang, Y., Chen, J., et al. (2019) The Impact of Antibiotic Resistance on Surgical Outcomes. International Journal of Surgery, 25, 45-50.
[15]
Lee, K.H., Park, H., Choi, J., et al. (2018) Antibiotic Resistance Patterns in Surgical Site Infections: A Retrospective Study. BMC Surgery, 18, 23-30.
[16]
Jones, R., Smith, L., Taylor, M., et al. (2021) The Burden of Antibiotic Resistance in Surgery and Trauma. Surgical Infections, 22, 345-358.
[17]
Patel, S., Reddy, K., Cohen, J., et al. (2019) Trends in Antibiotic Resistance and Clinical Outcomes in Surgical Patients. Annals of Surgery, 270, 873-878.
[18]
Wilson, D., Black, J., Green, M., et al. (2020) Methicillin-Resistant Staphylococcus Aureus: A Growing Concern in Surgical Patients. Infection Control & Hospital Epidemiology, 41, 329-335.
[19]
Brown, J., Harper, A., Smith, R., et al. (2022) Resistance Patterns of Staphylococcus Aureus in Postoperative Infections. Journal of Hospital Medicine, 17, 405-411.
[20]
Green, M., Thompson, J., Lee, C., et al. (2021) Antibiotic Stewardship in Surgical Settings: A Systematic Review. Surgery Today, 51, 1123-1133.
[21]
Taylor, R., Lee, S., Kim, H., et al. (2019) The Role of Skin Flora in Postoperative Infections. British Journal of Surgery, 106, 173-180.
[22]
Miller, A., Johnson, K., Patel, S., et al. (2021) Escherichia Coli in Surgical Site Infections: A Review of the Literature. The American Journal of Surgery, 221, 482-489.
[23]
Johnson, K., Miller, R., Smith, T., et al. (2020) The Pathogenicity of Escherichia Coli in Surgical Infections: Insights and Implications. Infect, 48, 567-576.
[24]
Kim, Y,. Lee, J., Choi, S., et al. (2019) Risk Factors for Antibiotic Resistance in Postoperative Infections: A Cohort Study. Journal of Clinical Microbiology, 57, E00678-19.
[25]
Alvarez, J., Lopez, E., Garcia, M., et al. (2020) Risk Factors and Outcomes of Antibiotic-Resistant Infections in Surgical Patients. Journal of Infection, 80, 490-498.
[26]
Chen, T., Huang, X., Zhang, G., et al. (2021) The Implications of Antibiotic Misuse on Resistance Patterns in Surgical Infections. Surgical Infections, 22, 102-110.
[27]
Roberts, M., Smith, J., Brown, A., et al. (2019) The Economic Burden of Antibiotic Resistance in Healthcare Settings: A Systematic Review. Health Affairs, 38, 1575-1582.
[28]
Thompson, P., Walker, T., Lee, D., et al. (2022) Customizing Antibiotic Therapy Based on Microbial Susceptibility: A Clinical Perspective. Clinical Microbiology Reviews Journal, 35, E00210-21.
[29]
Wilson, A., Green, T., Patel, R., et al. (2020) Personalized Medicine in Antibiotic Therapy: Importance and Challenges. Nature Reviews Microbiology, 18, 668-679.
[30]
Morales, R., Kim, Y., Zhang, H., et al. (2021) Advances in Rapid Diagnostic Testing for Antibiotic Resistance: A Review. Frontiers in Microbiology, 12, Article 654321.
[31]
Carter, S., Thompson, P., Lee, J., et al. (2021) The Impact of Rapid Diagnostics on Antibiotic Prescribing in Surgical Infections. Clinical Infectious Diseases, 72, 1058-1064.
[32]
Walker, T., Smith, J., Johnson, A. and Lee, R. (2022) Monitoring Healthcare-Associated Infections: Challenges and Outcomes. American Journal of Infection Control, 50, 20-27.
[33]
Liu, A., Zhang, Y., Wang, Z., et al. (2022) The Role of Microbiome in Surgical Site Infections: Emerging Insights. Journal of Clinical Microbiology, 60, 345-352.
[34]
Patel, A., Gupta, R., Smith, J., et al. (2022) Surgical Site Infections: The Role of Preoperative Skin Antiseptics and Their Effectiveness. Journal of Orthopaedic Surgery and Research, 17, 123-130.
[35]
Turner, N., Chen, S., Roberts, M., et al. (2021) Postoperative Infections and Antibiotic Stewardship: A Comprehensive Review. The American Journal of Surgery, 221, 996-1004.
[36]
Wilson, R., Brown, H., Lee, J., et al. (2020) Infection Control Measures and Antibiotic Resistance in Surgical Settings: A Global Perspective. Infection Control & Hospital Epidemiology, 41, 360-365.
[37]
Zhang, Q., Li, T., Huang, J., et al. (2021) Effects of Antibiotic Prophylaxis on Postoperative Infection Rates: A Meta-Analysis. Journal of Clinical Anesthesia, 72, Article ID: 110287.
[38]
Cheng, Y., Zhao, Y., Wang, Q., et al. (2022) The Relationship between the Timing of Antibiotic Administration and Surgical Site Infection Rates: A Systematic Review. Surgical Infections, 23, 123-130.
[39]
Wong, S., Green, T., Smith, R., et al. (2021) Cost-Effectiveness of Antibiotic Stewardship Interventions in Surgical Settings: A Systematic Review. Value Health, 24, 1566-1573.
[40]
Chen, X., Liu, Y., Wang, L., et al. (2020) The Impact of Obesity on Surgical Site Infections: A Review of Recent Literature. Journal of the American College of Surgeons, 231, 239-247.
[41]
Taylor, J., Brown, A., Patel, R,. et al. (2021) The Effects of Diabetes on Postoperative Infection Rates: A Meta-Analysis. Diabetes Care, 44, 1912-1919.
[42]
Smith, T., Lee, D., Kim, H., et al. (2020) Multidrug-Resistant Organisms in Surgical Infections: A Global Challenge. Annals of Surgery, 272, 596-603.
[43]
Brown, C., Johnson, M., White, J., et al. (2022) Evaluating the Role of Gut Microbiota in Surgical Recovery: Implications for Future Research. Journal of Surgical Research, 284, 123-130.
[44]
Wang, H., Chen, Y., Zhao, Y., et al. (2021) Probiotics for the Prevention of Surgical Site Infections: A Systematic Review and Meta-Analysis. Nutrients, 13, Article 1257.
[45]
Robinson, K., Patel, A., Smith, J., et al. (2021) The Effect of Smoking on Surgical Outcomes: A Review of the Literature. Journal of Surgical Research, 267, 314-320.
[46]
Li, J., Zhang, X., Chen, Z., et al. (2020) The Impact of Surgical Technique on Infection Rates: A Systematic Review. Annals of Surgery, 272, 865-873.
[47]
Green, R., Taylor, M., Wong, A., et al. (2021) Strategies for Reducing Surgical Site Infections: A Focus on Enhanced Recovery After Surgery (ERAS) Protocols. Journal of Trauma and Acute Care Surgery, 90, 786-794.
[48]
Kim, S., Lee, J., Park, H., et al. (2020) Evaluating the Association Between Surgical Team Experience and Postoperative Infection Rates. Journal of the American College of Surgeons, 231, 447-454.
