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 re⁃view

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。

Abstract:

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 careful-ly and as early as possible to avoid the destruction of the healthy side of the bone by inflammatory factors, accelerating the process of osteoar-thritis. Gram-negative and conditionally pathogenic infections are rare and poorly detected after UKA. Metagenomic next-generation se-quencing (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 cli-nicians.