Analysis of pathogen distribution and drug resistance of 142 cases of periprosthetic infection after total hip arthroplasty

Abstract:

Objective To study and analyze the pathogen distribution and drug resistance of infection after total hip arthroplasty.Methods A total of 142 cases of infection after artificial hip arthroplasty in Xinqiao Hospital，Army Medical University from January 2015 to March 2022 were analyzed retrospectively. The wound secretions and focus tissues were taken for bacterial species identification and drug resistance analysis.Results A total of 156 strains of pathogenic bacteria were isolated from 142 patients with infection after total hip arthroplasty and there were 11 patients with mixed infection，accounting for 7.75%. Gram-positive bacteria accounted for 64.10%（100 strains），of which Staphylococcus aureus and Staphylococcus epidermidis accounted for 33.33% and 16.67%，respectively. Gram-negative bacteria accounted for 33.98%，of which Pseudomonas aeruginosa and Escherichia coli accounted for 14.74% and 10.26%，respectively. Staphylococcus aureus and Staphylococcus epidermidis in gram-positive bacteria were highly resistant to penicillin，ampicillin，oxacillin，erythromycin，amoxicillin/clavulanic acid（all more than 50%）and sensitive to quinoloptin/daptidine，vancomycin and linazolidine. Pseudomonas aeruginosa in gram-negative bacteria was sensitive to antibiotics such as cefoperazone，cefuroxime and piperacillin，while Escherichia coli was highly resistant to tetracycline，ampicillin，ciprofloxacin and gentamicin（all more than 50%），and sensitive to cefoperazone/sulbactam，minocycline，tetracycline，aztreonam，sulfamethoxazole and imipenem.Conclusion Gram-positive bacteria，including Staphylococcus aureus and Staphylococcus epidermidis，are the main infections after total hip arthroplasty. Quinuprotin/daptidine，vancomycin and linezolid can be used as the first choice for empirical treatment of infection after total hip arthroplasty.