单髁置换术嗜麦芽窄食单胞菌感染:1例报告和综述  

Stenotrophomonas maltophilia infection secondary to unicompartmental knee arthroplasty:a case report and literature review

作　　者：陈宇浩 张伟[1] 吴沼锋 赵继军 CHEN Yu-hao;ZHANG-Wei;WU Zhao-feng;ZHAO Ji-jun(Wuxi Medical Center,Nanjing Medical University,Wuxi 214023,China;People's Hospital of Wuxi City,Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学无锡医学中心,江苏无锡214023 [2]南京医科大学附属无锡人民医院,江苏无锡214023

出　　处：《中国矫形外科杂志》2023年第23期2159-2165,共7页Orthopedic Journal of China

摘　　要：膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)是膝关节骨性关节炎阶梯化治疗的关键方案,有切口小、创伤小、出血少、手术时间及住院时间短等优势,近年来UKA手术适应证已逐渐扩大,手术量也逐年增加。但也因UKA保留健侧组织的特殊性,其术后假体周围感染(periprosthetic joint infection,PJI)的处理也应更加慎重,需尽快处理,避免健侧骨质受到炎性因子破坏而加快关节炎进程。UKA术后革兰氏阴性菌及条件致病菌感染少见,且检出率低,宏基因组下一代基因测序(metagenomic next-generation sequencing,mNGS)则是明确感染病原微生物的有效手段,可以指导临床针对性用药。本文就本院收治的1例单髁术后嗜麦芽窄食单孢菌急性感染进行报道,以供临床参考。Unicompartmental knee arthroplasty(UKA)is an important option in the staged treatment of osteoarthritis of the knee,withthe advantages of small incisions,minimal trauma,less bleeding,shorter operative time and shorter hospital stay.However,due to the uniquenature of UKA in preserving the healthy side of the tissue,post-operative periprosthetic joint infection(PJI)should be managed more carefully and as early as possible to avoid the destruction of the healthy side of the bone by inflammatory factors,accelerating the process of osteoarthritis.Gram-negative and conditionally pathogenic infections are rare and poorly detected after UKA.Metagenomic next-generation sequencing(mNGS)is an effective tool to identify the pathogenic organisms of infection and can guide the clinical use of targeted drugs.In thispaper,we report a case of acute infection with stenotrophomonas maltophilia after UKA with a literature review to provide a reference for clinicians.

关 键 词：膝关节单髁置换术 假体周围感染 宏基因组下一代基因测序 

分 类 号：R687.4[医药卫生—骨科学]