Mycobacterium farcinogenes infection after total hip arthroplasty

Atypical mycobacterium infection after total hip arthroplasty is a very rare but a potential cause of implant failure. We present the first report of Mycobacterium farcinogenes infection in human beings. Although the treatment of atypical mycobacterium infection after total hip arthroplasty is controversial, we successfully treated the infection in this case, after consultation with a microbiologist regarding infection management, with both surgery and chemotherapy. It is important to maintain a high index of suspicion for atypical mycobacterium infection, particularly when standard culture findings are negative despite strong clinical evidence of prosthesis infection.     

A study of telephone screening and direct observation of surgical wound infections after discharge from hospital

Post-discharge surveillance of surgical site infection is necessary if accurate rates of infection following surgery are to be available. We undertook a prospective study of 376 knee and hip replacements in 366 patients in order to estimate the rate of orthopaedic surgical site infection in the community. The inpatient infection was 3.1% and the post-discharge infection rate was 2.1%. We concluded that the use of telephone interviews of patients to identify the group at highest risk of having a surgical site infection (those who think they have an infection) with rapid follow-up by a professional trained to diagnose infection according to agreed criteria is an effective method of identifying infection after discharge from hospital.     

无张力疝修补术后切口感染分析

目的探讨无张力疝修补术后切121感染的防治。方法回顾性分析同期腹股沟疝无张力修补与传统疝修补术后切口感染率并进行比较。结果无张力疝修补的术后切口感染率为0．40％，传统疝修补术后切口感染率为0．50％。两种术式术后切口感染率相比差异无统计学意义（P〉0．05）。结论腹股沟疝无张力修补虽然有异体材料植入，但并不增加术后切口感染机率，严格遵守无菌手术原则才是预防术后切口感染的关键。     

封闭式负压引流治疗软组织感染

目的探讨封闭式负压引流治疗软组织感染的疗效。方法应用封闭式负压引流治疗开放性骨折发生软组织感染18例。结果18例均获随访,时间6个月-1年6个月。软组织感染均愈合,骨折正常愈合12例,延迟愈合6例,无慢性骨感染发生。结论封闭式负压引流治疗软组织感染,可短期控制感染,为进一步治疗创造条件,尤其适用于深部软组织感染患者。手术简单,疗效可靠,适合基层医院应用。     

肾移植术后肺部感染的诊疗

目的 探讨肾移植术后肺部感染发病特点及有效的临床诊疗措施.方法 对我院2012年1月至2016年2月49例肾移植术后发生肺部感染患者的临床资料进行回顾性分析.结果 49例肾移植术后肺部感染的患者中,细菌感染者22例,真菌感染者18例,病毒感染者7例,支原体、衣原体感染者各1例.其中31例发生于术后半年以内,28例为混合感染.住院治疗后46例康复出院,3例因重度肺部感染死亡.结论 肾移植术后肺部感染发生率和病死率高,在明确感染病原体之前可采用经验性抗感染治疗,待培养和药敏试验结果出来时及时选择有效的治疗药物.     

上颈椎损伤患者深部真菌感染流行病学调查

目的对上颈椎损伤合并真菌感染患者进行回顾性分析,探讨其临床特点及其抗真菌治疗对预后的影响.方法2000年1月至2002年12月共收治上颈椎损伤患者336例,其中38例合并真菌感染,比较真菌感染与非真菌感染这两组患者的一般情况、抗生素应用情况、真菌感染部位和感染菌种、抗真菌疗效及两组患者死亡率.结果真菌感染发生率为11.31%,真菌感染组患者病死率39.47%,非真菌感染组患者病死率18.12%,两组比较存在显著性差异(P＜0.01).感染菌种以白色念珠菌和热带念珠菌居多,感染部位主要集中在呼吸道及泌尿道,抗真菌治疗总有效率为60.53%.结论上颈椎损伤合并深部真菌感染患者病死率明显升高,应及时开展早期经验性抗真菌治疗,选择有效的抗真菌药物,以期降低患者的病死率.     

男性沙眼衣原体感染的研究进展

生殖道沙眼衣原体 (Ct)感染为目前最常见的性传播疾病之一 ,然而对男性Ct感染的研究相对较少。本文对男性Ct感染的流行病学、Ct感染与男科疾病及男性不育、男性Ct感染的检测等进行了综述 ,以期给男性Ct感染的预防和控制提供理论基础和实际指导。     

尿道下裂的细菌学研究

目的 探索尿道下裂术后的再造尿道易于感染的原因、感染源及细菌种类；据此改进围手术期处理措施，以降低感染率。方法 应用细菌培养鉴定、基因分型鉴定等从分子水平证实细菌的来源及种类。结果 经尿道外口逆行进入和再造尿道材料携带是细菌主要来源。引起尿道下裂感染主要是革兰氏阳性球菌。最有效抗生素是去甲万古霉素。结论 尿道下裂术后感染是切口感染而不是泌尿系感染。再造尿道感染率高于皮肤(黏膜)的原因在于造成了比体表更适合细菌生长繁殖的微环境。     

肝移植术后巨细胞病毒感染的防治研究

目的 探讨肝移植术后患者巨细胞病毒(CMV)感染的诊治经验。方法回顾分析我科2001年1月至2002年12月期间进行的96例同种异体肝移植病例的临床资料。结果发生巨细胞病毒感染19例,均检测到CMV抗原IE-E和CMV抗原PP65,其中CMV-IgM( )8例。在CMV感染的患者中,出现呼吸窘迫3例,发热4例,黄疸2例,14例无明显症状。经更昔洛韦治疗后18例患者血CMV抗原IE．E和CMV抗原PP65转变为阴性,1例患者死于间质性肺炎。结论肝移植后CMV感染与多种因素有关,积极预防、早期治疗肝移植术后患者CMV感染至关重要,CMV抗原检测的应用能够对CMV感染患者作出早期诊断并且指导治疗,更昔洛韦能够有效治疗CMV感染。     

The diagnosis and management of infection following instrumented spinal fusion

A 10-year retrospective audit. (1) The incidence of infection; (2) causative organisms; (3) whether eradication of infection is achievable with spinal implant retention; (4) patient outcome. The reported incidence of infection following posterior spinal instrumentation is between 2.6 and 3.8%. Management of infection is controversial, with some advocating serial wound debridement while others report that infection cannot be eradicated with retention of implants. There are no published data demonstrating that propionibacteria are associated with early postoperative infection. The management of infected cases at our institution includes eventual removal of their implants. Our population was identified by studying the case notes of all patients who had undergone removal of spinal implants and cross-referencing this population with positive microbiology or histology reports. The incidence of infection was 3.7%. Propionibacteria were isolated in 45% of cases. The diagnosis of infection was unexpected in 25% of patients, following removal of implants for prominence of implants or back pain. Sixty per cent of patients with acute postoperative deep wound infection had continuing active infection on subsequent removal of implants, despite long-term antibiotics and wound debridement. Fourty-six per cent of patients had a stable, pain-free spine at the end of their treatment. This is the largest reported series of infections following posterior spinal instrumented fusions of which we are aware. Propionibacteria are a common cause of infection and successful eradication of infection cannot be reliably achieved with antibiotics and wound debridement alone.     

Factors affecting infection after calcaneal fracture fixation

A retrospective study of 178 operatively managed intra-articular calcaneal fractures was undertaken. The primary purpose of the study was to investigate whether delay prior to surgery was related to the prevalence of post-operative deep infection although other factors related to infection were also examined.The deep infection rate was 5.6% but there was no statistical correlation between surgical delay and deep infection. However analysis of the results showed that surgical experience did correlate with deep infection. The infection rate for a group of inexperienced surgeons was 14.3% compared with 2.8% for the most experienced surgeon in the study. Analysis also indicated a trend towards more socially deprived patients having a higher rate of infection but it was only in drug addicts where there was a significantly increased rate of deep infection. Other factors such as smoking, fracture severity and wound closure did not affect the rate of deep infection.Our study shows that delay prior to calcaneal fracture surgery is not associated with a lower infection rate but it is does indicate that surgical experience is important and we believe that these difficult fractures should be treated in specialised centres.     

解脲支原体感染与抗精子抗体阳性及其男性不育症的关系

目的：探讨在男性不育症中解脲支原体感染与抗精子抗体阳性的关系。方法：采用混合抗球蛋白反应方法检测50例尿道分泌物解脲支原体Uu阳性不育症患者精液中抗精子抗体与56例尿道分泌物解脲支原体Uu阴性不育症患者精液中抗精子抗体。结果：在106例不育症患者中，解脲支原体Uu阳性组患者精液中抗精子抗体阳性率是68％，明显高于解脲支原体Uu阴性组患者精液中抗精子抗体阳性率16．1％（P〈O．01）。结论：男性生殖道解脲支原体Uu感染与精液中抗精子抗体的产生有相关性，对男性生育有不良影响。     

Pseudomonal breast infection

Breast infection and breast sepsis secondary to Pseudomonas aeruginosa is uncommon. We report two cases of pseudomonal breast infection leading to septic shock and abscess formation in women with non-responding breast infection. The management of breast infection is broad-spectrum antibiotics and ultrasound with aspiration of any collection. To treat breast infection effectively, the causative organism must be isolated to enable appropriate antibiotic therapy.     

腰椎后路椎间融合（PLIF）术后深部感染手术治疗

目的 探讨腰椎后路椎间融合（PLIF）术后深部感染的诊断、治疗特点。方法通过对8例PLIF术后深部感染的检查及手术治疗，总结诊断PLIF术后深部感染的敏感指标、有效的治疗方法。结果血沉、CRP是诊断及监测PLIF术后深部感染的敏感化验指标；MRI对诊断急性感染有确诊意义，对诊断慢性感染早期意义不大；内固定牢固者可以保留内固定，不影响对感染的治疗；神经根刺激症状恢复不如腰痛症状恢复明显；所有病人经过规范治疗均在3个月内治愈。结论PLIF术后深部感染通过规范治疗，完全可以治愈，预后良好。     

The severity of infection stones compared to other stones in the upper urinary tract

A retrospective study of the case records of 391 adult patients with spontaneously passed or surgically removed concrements from the upper urinary tract during the period 1982-1983 was performed. According to chemical analysis, 66% of the stones were calcium stones, 30% were infection stones, 4% were uric acid/urate stones and 1% were cystine stones. Of the infection stones 12 (10%) were staghorn calculi. The infection stones placed a greater strain on the patients than the calcium stones. Thus, infection stones were significantly more often recurrent stones and required surgery significantly more often than the calcium stones. Only 6% of the patients with infection stones had proved abnormalities predisposing to upper urinary tract infection. Urinary tract infection with a urease-producing microorganism was detected in only 52% of the patients with infection stones. As infection with a urease-producing microorganism is a prerequisite for the formation of infection stones in the urinary tract a careful microbiological investigation to find and treat the infection responsible for the stone formation is mandatory.     

Rubella--a reappraisal

Rubella infection is reviewed and new information about congenital infection, possible sources of infection in pregnant women and the optimum ages and population groups for rubella vaccination is considered. Investigations required to confirm a suspected and possibly 'silent' infection during pregnancy are outlined.     

Varicella Infection Following Varicella Vaccination in a Liver Transplant Recipient

Varicella infection may result in significant morbidity and mortality in patients who have received an orthotopic liver transplant (OLT). It is unclear if vaccinating these patients against varicella-zoster virus (VZV) infection is safe or effective. We report on a liver transplant recipient with no prior history of VZV infection who was given the varicella vaccine after an indirect VZV exposure. The patient was subsequently hospitalized twice for treatment of cutaneous varicella infection. We will discuss VZV infection, particularly in relation to liver transplantation, and review the prophylaxis and management of VZV infection after OLT.     

Fatal disseminated adenoviral infection in a renal transplant patient

Immunosuppressed patients are more susceptible to adenoviral infection and carry a significantly higher mortality than immunocompetent patients. Renal transplant patients with adenoviral infection most often present with infection of the kidney and urinary tract within weeks to months of transplant surgery, suggesting reactivation of the latent adenovirus in the immunosuppressed host as the source of infection. We describe the first case of a fatal adenovirus infection after several years of immunosuppression in a kidney transplant patient. Postmortem examination of several tissues, using standard viral culture and polymerase chain reaction, was positive for adenovirus serotype 21. This case is unusual in that the fatal disseminated viral infection occurred after 6 years of immunosuppression, suggesting that the source of adenovirus was a novel infection rather than reactivation of latent infection, or infection from the transplanted tissue. Furthermore, this is the first report of adenovirus type 21 in an immunosuppressed patient.     

围手术期肺部感染细菌学的变迁及对策

呼吸道感染已成为手术病人并发感染的首位原因,其病原菌的变迁是动态的,目前革兰阴性（G-）杆菌是肺部感染的主要致病菌,革兰阳性（G+）菌和真菌的发病率在逐年增加。随着广谱抗生素的大量应用,主要致病菌耐药性日趋严重。积极应对策略包括：科学、合理应用抗生素以及采取各种有效措施,降低围手术期院内肺部感染的发生率。     

The patient with a clotted PTFE graft developing fever

Haemodialysis access graft infection is easily recognizable when local symptoms (warmth, swelling, pain, or drainage) predominate, and endocarditis is a well established complication of infected grafts. We report a case of bacterial endocarditis complicating silent infection in clotted haemodialysis access graft. It is suggested that, clotted non-functioning grafts may be the harbingers of silent infection, and should be suspected as the source of infection in every haemodialysis patient that presents with fever, even in the absence of clinical signs of graft site infection.