摘要
骨科感染是临床上常见且处理较为复杂的疾病,包括假体周围感染、骨髓炎、术后切口感染等多种类型,不仅显著延长患者治疗周期,增加医疗负担,严重时还可导致功能障碍甚至截肢。病原微生物的早期识别与药敏检测,对指导抗生素合理使用、延缓耐药发生及改善患者预后具有重要意义。本文系统综述骨科感染常见病原菌的分布特点,重点分析革兰阳性菌(如金黄色葡萄球菌、表皮葡萄球菌)与革兰阴性菌(如铜绿假单胞菌、肺炎克雷伯菌)的检出趋势及其随时间变化的菌群更替现象;深入探讨生物膜形成、抗生素靶点改变及外排泵系统激活等耐药机制;并评述当前常用及新兴的检验诊断技术,包括传统药敏试验、免疫磁珠分离技术、分子生物学方法(如多重PCR、宏基因组测序)的应用现状与局限性。旨在为骨科感染病原学的精准诊断与个体化抗感染治疗提供理论依据与新技术视角。
Orthopedic infection is a common and complicated disease in clinic,including periprosthetic infection,osteomyelitis,postoperative incision infection and other types,which not only significantly prolongs the treatment cycle of patients and increases the medical burden,but also leads to dysfunction or even amputation in severe cases.Early identification and drug sensitivity detection of pathogenic microorganisms are of great significance to guide the rational use of antibiotics,delay the occurrence of drug resistance and improve the prognosis of patients.In this paper,the distribution characteristics of common pathogenic bacteria in orthopedic infections are systematically reviewed,and the detection trends of gram-positive bacteria(such as Staphylococcus aureus and Staphylococcus epidermidis)and gram-negative bacteria(such as Pseudomonas aeruginosa and Klebsiella pneumoniae)and their time-varying flora replacement phenomena are emphatically analyzed.In-depth discussion on the mechanism of drug resistance such as biofilm formation,changes in antibiotic targets and activation of efflux pump system;The application status and limitations of commonly used and emerging diagnostic techniques,including traditional drug sensitivity test,immunomagnetic bead separation technology and molecular biology methods(such as multiplex PCR and metagenome sequencing),are also reviewed.It aims to provide theoretical basis and new technical perspective for accurate diagnosis and individualized anti-infection treatment of orthopedic infection etiology.
作者
王晓燕
唐金蓉
宋俐
WANG Xiaoyan;TANG Jinrong;SONG Li(Department ofLaboratory Medicine,Mianyang Hospitalof Traditional Chinese Medicine,Mianyang,Sichuan 621000,China)
出处
《中国病原生物学杂志》
北大核心
2026年第3期420-423,共4页
Journal of Pathogen Biology
关键词
骨科感染
病原微生物菌群分布特征
耐药机制
检验诊断技术
综述
orthopedic infections
distribution characteristics of pathogenic microbial flora
mechanisms of drug resistance
laboratory diagnostic techniques
review
