학술논문
Enterobacter cloacaeInfection After Surgical Treatment of Ankle Fractures, a Multicenter Observational Study
Document Type
Article
Author
García Cardona, Carlos; Bernaus Johnson, Martí Carles; Martínez Ros, Javier; Hernández-Gonzalez, Nerea; Auñon Rubio, Álvaro; Anglès Crespo, Francesc; Arteagoitia-Colino, Iraia; Coifman-Lucena, Ismael; Esteban-Moreno, Jaime; Moral Escudero, Encarnación; Gómez García, Lucía; Nóvoa Martínez, Ricardo; Ortega Columbrans, Ana; Veloso Duran, Margarita; Font-Vizcarra, Lluís
Source
Foot and Ankle International; May 2023, Vol. 44 Issue: 5 p424-430, 7p
Subject
Language
ISSN
10711007; 19447876
Abstract
Background: Infection is one of the challenging complications after open reduction and internal fixation for ankle fractures. Previously published case series conclude that Staphylococcus aureusis the most frequent causative microorganism. An unexpected increase in Enterobacter cloacaeinfections after this surgery was observed in a preliminary analysis of data at the promoting center of the study. In traumatology, its incidence has been reported in chronic osteomyelitis, prosthetic infections, septic osteoarthritis, open fractures in children and adults, and fractures other than the ankle. Because of this unexpected finding, we decided to perform this study to analyze the demographic and microbiological variables of acute osteosynthesis infection after ankle fracture and determine the distinctive features of the patients with E cloacaeinfection.Methods: We performed a retrospective multicenter study including 4 university hospitals. All patients diagnosed with acute osteosynthesis infection after ankle fracture fixation between January 2015 and December 2018 were included. We analyzed demographic data, type of fracture, surgical technique, and microorganisms responsible for the infection. We performed a descriptive statistical analysis of the variables. Univariate and multivariate regression analysis were performed to compare patients with E cloacaeinfection to patients with infection caused by other microorganisms.Results: A total of 65 patients were included. A predominance of polymicrobial infections (24.62%), followed by infections caused by S aureus(23.07%) and E cloacae(23.07%) was observed. When E cloacaeisolated in polymicrobial infections were added, the incidence of E cloacaeas a causative microorganism increased to 32.3%. Patients with E cloacaeinfection were older (64/53, P= .008) and had a higher requirement of negative-pressure therapy after surgical debridement (71%/40%, P= .017).Conclusion: A high incidence of E cloacaeinfections was observed. Patients with E cloacaeinfection were generally older and required a higher use of negative-pressure therapy after debridement.Level of Evidence: Level V, mechanism-based reasoning.