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[Multicentre study of infection incidence in knee prosthesis].[Article in Spanish]
Jaén F, Sanz-Gallardo MI, Arrazola MP, García de Codes A, de Juanes A, Resines C; Grupo de Trabajo INCLIMECC de la Comunidad de Madrid.
SourceServicio de Medicina Preventiva, Hospital Universitario 12 de Octubre, Madrid, España.
AbstractOBJECTIVE: To determine the incidence of surgical site infection in knee prosthesis surgical procedure for a follow-up period of one year in twelve hospitals in Madrid region.
MATERIAL AND METHOD: A prospective study was carried out from January to December 2009 using a national surveillance system called Indicadores Clínicos de Mejora Continua de Calidad. Primary and revision knee joint replacements in patients operated on in the previous year were included. Criteria used to define surgical site infection and patient risk index categories were those established by the Centers for Disease Control and Prevention and National Nosocomial Infections Surveillance. The incidence rates were worked out crude and adjusted by hazard ratio.
RESULTS: 2,088 knee prosthesis procedures were analyzed. The overall incidence of surgical site infection was 2.1%. Sixty-five percent of the infections were organ/space. Sixty percent of the infections were identified in the early postoperative period. Of all surgical site infections, 41.9% were microbiologically confirmed. Antibiotic prophylaxis was implemented correctly in 63.3% of the cases. The most important cause of inappropriate prophylaxis was an unsuitable duration in 85.7% of the cases. The presurgical preparation was carried out correctly in 50.3% of surgical operations. The incidence of knee arthroplasty infection was twice as high as in the National Healthcare Safety Network and similar to national rates.分析了2088例膝关节置换手术，总体SSI发病率为2.1%，其中65%为器官/腔隙感染，60%的感染在手术后早期被确认，41.9%得到微生物学证实。63.3%的手术患者抗菌药物预防性使用合理，其中最重要的不合理使用的原因使用疗程不当占85.7%。50.3%的手术术前准备正确。膝关节置换SSI发病率是美国NHSN的2倍，与西班牙全国的发病率相似。
DISCUSSION: In this study, the incidence of infection was within the range of infection rates in other published European studies. Surveillance and control strategies of health care for associated infections allow us to assess trends and the impact of preventive measures.本研究的SSI发病率没有超过欧洲其它研究报道的数据。感染有关监测和控制策略使我们可以评估的发病趋势和预防措施的影响。
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发表于 2012-12-5 08:34
发表于 2012-12-6 22:54
据我院到德国学习的人说，德国膝关节置换术感染率远高于我院。在我院发生膝关节置换感染，都可以算是医疗事故了，而据说他在德国期间就亲见发生二例膝关节置换感染，居然也没有出现医疗纠纷，似乎是很正常的一件事。不过此事非本人亲身经历，仅供参考
发表于 2012-12-11 08:55
这似乎在我们国内是一件不可想象的事情。不过大家不要看了我上面的描述，就认为德国还不如我国，那可就犯了大错了，其他好的方面由于与这个话题关系不大，同时限于时间关系我只是没有介绍罢了
引用一句名言：洋为中用，弃去糟粕，用其精华
