66 Cases Of Implant-related Chronic Osteomyelitis Microflora Characteristics And Drug Resistance Analysis

Objective:Statistics my department 66 cases of patients with implant-related chronic osteomyelitis and analyze microflora characteristics and drug resistance situation, to provide the assistance for clinical treatment of osteomyelitis.Methods:Statistics my department, from March 2012 to December 2014, 66 cases of patients with implant-related chronic osteomyelitis, analyze bacterial culture and drug sensitive test data.(1) Female in 13 of 66 patients,male 53 cases, the youngest patients was 12 years old,the oldest is 68 years old, an average of 41 years old. Divided parts: hip in 5 cases、femoral in 24 cases、tibia in 30 cases、fibula in 2 cases、ankle in 4 cases 、calcaneus in 2 cases,humerus in 1case and ulna in 1 case.(2) Dab pus of antrum sterile from 17 cases of patients before operation for specimens. Get specimens during primary surgical debridement from all of the patients who cease using antibiotics for 1 week, and take 6specimens of different position(dead bone, internal fixation, fester, deep necrotic tissue,bone marrow, bone at the junction between necrosis and normal).Results:1. Find 96 strains of 21 species pathogenic bacteria from 66 cases of patients, in which3 kinds from 3 patients,2 kinds from 24 cases,a single bacteria from 39 patients. Cultivate57 strains gram-positive bacteria,accounted for 59.38%; 38 strains of gram-negative bacteria,accounted for 39.58%, a smooth candida from 1 case of fungi,accounted for1.04%.31 strains of Staphylococcus aureus,the highest proportion in the total bacteria,accounted for 32.29%, followed by: pseudomonas aeruginosa( 11.46%), methicillin resistant staphylococcus aureus(MRSA)(9.38%), epidermis staphylococcus(9.38%)and e. coli( 8.33%). MRSA account for 29.03% of staphylococcus aureus.2. Multiple drug-resistant bacteria are isolated from 34 cases,accounted for 35.42%, the top four is:staphylococcus aureus(26.47%),the epidermis staphylococcus(26.47%), e. coli(14.71%),pseudomonas aeruginosa(8.82%). For Gram-positive bacteria the lowest drug resistance to commonly used antibiotics is vancomycin, rina thiazole alkanes, the highest is penicillin.MRSA resist to most antibiotics, which do not resist to vancomycin. Imipenem are the lowest class of drug resistance to antibiotics, the highest is ampicillin class.The resistance of pseudomonas aeruginosa to amikacin, meropenem and quinolones is equally 8.33%,it has highly resistant to most of cephalosporins.3. The difference rate of culture bacteria of17 cases of patients between preoperation and intraoperation, which 8 cases is different, is47.06%.Conclusion:1.In patients with implant-related chronic osteomyelitis, the account of gram-positive bacteria is more than that of gram-negative bacteria. 2. The proportion of multi-resistant bacteria accounts for nearly a third. 3. Get specimen regulately to improve the accuracy in cultivating pathogenic bacteria.