Analysis of the occurrence of infection and distribution characteristics of pathogenic bacteria after internal fixation of open limb fractures

ZHANG Tian; CHEN Chun-ran; LI Chun-guang

doi:10.3969/j.issn.2095-252X.2026.03.006

Abstract：Objective To investigate the incidence of infection and the distribution characteristics of pathogenic bacteria after internal fixation of open limb fractures,in order to provide reference for the development of clinical intervention programs.Methods A total of 410 patients with open limb fractures treated in our hospital from January 2021 to January 2025 were retrospectively selected as the research objects.All patients underwent internal fixation after admission.The incidence of postoperative infection was counted,the distribution characteristics of pathogenic bacteria and drug resistance of main pathogenic bacteria were analyzed,and the clinical data of infected and non-infected patients were compared.Logistic regression equation was used to analyze the influencing factors of infection after internal fixation of open limb fractures.Results A total of 94 cases of infection occurred in 410 patients with open limb fractures;121 strains were isolated,of which 75 strains of Gram-negative bacteria accounted for 61.98%,mainly Escherichia coli and Pseudomonas aeruginosa;38 strains of Gram-positive bacteria accounted for 31.40%,mainly Staphylococcus aureus and coagulase negative Staphylococcus.There were 8 fungal strains,accounting for 6.61%.Among the main Gram-negative bacteria,Escherichia coli had low resistance to imipenem and meropenem,and Pseudomonas aeruginosa had low resistance to imipenem and meropenem.Among the major Gram-positive bacteria,Staphylococcus aureus had relatively low resistance to rifampicin,vancomycin and Teicoplanin,while coagulase-negative Staphylococcus had relatively low resistance to vancomycin and Teicoplanin.There were statistically significant differences in the presence or absence of tension blisters,limb swelling,invasive operations,and whether surgical debridement was thorough between patients with postoperative infection and those without infection(P<0.05).Logistic regression equation analysis showed that tension blisters,limb swelling,invasive operations,and incomplete surgical debridement were all risk factors for infection after internal fixation of open limb fractures(P<0.05).Conclusions There is a relatively high incidence of infection after internal fixation of open limb fractures,mainly caused by Gram-negative bacteria,and there is certain drug resistance.For patients with postoperative infection in clinical practice,antibiotics should be reasonably selected based on the analysis of drug resistance of pathogenic bacteria.