Drug resistance monitoring and clinical analysis of Staphylococcus aureus in patients with infection after fracture internal fixation
Ji Ou
Zhong Ruixue
Liu Xiaoli
Chen Yunbei
Lang Zhigang
Duan Xiaoyun
Abstract：Objective To study the drug resistance and clinical characteristics of patients with Staphylococcus aureus with infection after fracture internal fixation.Methods Retrospective analysis was conducted for the medical records of inpatients with infection after fracture internal fixation caused by Staphylococcus aureus from January 2016 to December 2020 in Sichuan Orthopaedic Hospital.Totally 467 strains of Staphylococcus aureus were recorded.According to the drug susceptibility experiment,it was divided into methicillin-resistant Staphylococcus aureus(MRSA)group(145 strains)and methicillin-sensitive Staphylococcus aureus(MSSA)group(322 strains),and the resistance of the two groups to common antibacterial drugs was analyzed and compared.The minimum inhibitory concentration(MIC)of vancomycin on MRSA from 2016 to 2020 was counted.Results The resistance rate of Staphylococcus aureus to penicillin was 94.9％(443/467),the resistance rates to erythromycin,clindamycin,oxacillin and tetracycline were high,and the resistance rates to levofloxacin,rifampicin,compound sulfamethoxazde tablets,and moxifloxacin were low[8.4％(39/467),5.8％(27/467),3.6％(17/467),3.0％(14/467)],and no strains resistant to vancomycin,linezolid and daptomycin were found.Vancomycin mediated 3 strains.There were significant differences in the resistance rates between the MRSA group and the MSSA group for clinda-mycin,oxacillin,erythromycin,levofloxacin,moxifloxacin,penicillin,rifampicin,compound sulfamethoxazde tablets,and tetracycline(all P＜0.05).Vancomycin had a high proportion of MRSA with MIC of 2 mg/L.Conclusions The detection rate of MRSA in fracture internal fixation caused by Staphylococcus aureus is high.The proportion of vancomycin with MIC=2 mg/L is high,which reduces the standard rate of vancomycin in the treatment of post fracture internal fixation infection,and the permeability of vancomycin bone tissue is not high.Those increase the difficulty of clinical treatment.Therefore,vancomycin bone cement implantation combined with intravenous medication,or vancomycin,rifampicin,quinolones,sulfonamides and other combined drugs may be a better choice for the treatment of postoperative infection after fracture internal fixation.
Keywords：Staphylococcus aureusInfection after fracture internal fixationVancomycinDrug resistance
Publication Date：2024-04-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 571-575 )